#aadth ,,congress #b;d ,session ,in the ,house of ,representatives1 ,u4 ,s41 ,may #ac1 #bjaf ,,amendments3 ,that the bill from the ,senate 7,s4 #ebd7 entitled #8#8,an ,act to authorize the ,attorney ,general to award grants to address the national epidemics of prescription opioid abuse and heroin use4''1 do pass with the following ,strike out all after the enacting clause and insert3 #a4 ,table of ,contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,table of ,contents4 ,title ,i--,pain ,management ,best ,practices ,inter-,agency ,task ,force ,sec4 #aja4 ,development of best practices for the use of prescription opioids4 ,title ,,ii--,comprehensive ,opioid ,abuse ,reduction ,act ,sec4 #bja4 ,short title4 ,sec4 #bjb4 ,comprehensive ,opioid ,abuse ,grant ,program4 ,sec4 #bjc4 ,audit and accountability of grantees4 ,sec4 #bjd4 ,veterans treatment courts4 ,sec4 #bje4 ,emergency ,federal law enforcement assistance4 ,sec4 #bjf4 ,inclusion of services for pregnant women under family-based substance abuse grants4 ,sec4 #bjg4 ,,gao study and report on ,department of ,justice programs and research relative to substance use and substance use disorders among adolescents and young adults4 ,title ,,iii--,jason ,simcakoski ,,promise ,act ,sec4 #cja4 ,short title4 ,sec4 #cjb4 ,improvement of opioid safety measures by ,department of ,veterans ,affairs4 ,sec4 #cjc4 ,strengthening of joint working group on pain management of the ,department of ,veterans ,affairs and the ,department of ,defense4 ,sec4 #cjd4 ,review1 investigation1 and report on use of opioids in treatment by ,department of ,veterans ,affairs4 ,sec4 #cje4 ,mandatory disclosure of certain veteran information to ,state controlled substance monitoring programs4 ,sec4 #cjf4 ,modification to limitation on awards and bonuses4 ,title ,,iv--,kingpin ,designation ,improvement ,act ,sec4 #dja4 ,short title4 ,sec4 #djb4 ,protection of classified information in ,federal court challenges relating to designations under the ,narcotics ,kingpin ,designation ,act4 ,title ,v--,good ,samaritan ,assessment ,act ,sec4 #eja4 ,short title4 ,sec4 #ejb4 ,finding4 ,sec4 #ejc4 ,,gao ,study on ,good ,samaritan laws pertaining to treatment of opioid overdoses4 ,sec4 #ejd4 ,definitions4 ,title ,,vi--,,open ,act ,sec4 #fja4 ,short title4 ,sec4 #fjb4 ,evaluation of performance of ,department of ,justice program4 ,sec4 #fjc4 ,evaluation of performance of ,department of ,health and ,human ,services program4 ,sec4 #fjd4 ,definition4 ,sec4 #fje4 ,no additional funds authorized4 ,sec4 #fjf4 ,matters regarding certain ,federal law enforcement assistance4 ,title ,,vii--,infant ,plan of ,safe ,care ,improvement ,act ,sec4 #gja4 ,short title4 ,sec4 #gjb4 ,best practices for development of plans of safe care4 ,sec4 #gjc4 ,state plans4 ,sec4 #gjd4 ,data reports4 ,sec4 #gje4 ,monitoring and oversight4 ,sec4 #gjf4 ,rule of construction4 ,title ,,viii--,,nas ,healthy ,babies ,act ,sec4 #hja4 ,short title4 ,sec4 #hjb4 ,,gao report on neonatal abstinence syndrome 7,,nas74 ,sec4 #hjc4 ,excluding abuse-deterrent formulations of prescription drugs from the ,medicaid additional rebate requirement for new formulations of prescription drugs4 ,sec4 #hjd4 ,limiting disclosure of predictive modeling and other analytics technologies to identify and prevent waste1 fraud1 and abuse4 ,sec4 #hje4 ,medicaid ,improvement ,fund4 ,title ,,ix--,co-,prescribing to ,reduce ,overdoses ,act ,sec4 #ija4 ,short title4 ,sec4 #ijb4 ,opioid overdose reversal drugs prescribing grant program4 ,sec4 #ijc4 ,providing information to prescribers in certain ,federal health care and medical facilities on best practices for prescribing opioid overdose reversal drugs4 ,sec4 #ijd4 ,authorization of appropriations4 ,sec4 #ije4 ,cut-,go ,compliance4 ,title ,x--,improving ,treatment for ,pregnant and ,postpartum ,women ,act ,sec4 #ajja4 ,short title4 ,sec4 #ajjb4 ,reauthorization of residential treatment programs for pregnant and postpartum women4 ,sec4 #ajjc4 ,pilot program grants for ,state substance abuse agencies4 ,sec4 #ajjd4 ,cut-,go ,compliance4 ,title ,,xi--,veteran ,emergency ,medical ,technician ,support ,act ,sec4 #aaja4 ,short title4 ,sec4 #aajb4 ,assisting veterans with military emergency medical training to meet requirements for becoming civilian emergency medical technicians4 ,title ,,xii--,john ,thomas ,decker ,act ,sec4 #abja4 ,short title4 ,sec4 #abjb4 ,information materials and resources to prevent addiction related to youth sports injuries4 ,title ,,xiii--,lali's ,law ,sec4 #acja4 ,short title4 ,sec4 #acjb4 ,opioid overdose reversal medication access and education grant programs4 ,sec4 #acjc4 ,cut-,go ,compliance4 ,title ,,xiv--,reducing ,unused ,medications ,act ,sec4 #adja4 ,short title4 ,sec4 #adjb4 ,partial fills of schedule ,,ii controlled substances4 ,title ,,xv--,opioid ,review ,modernization ,act ,sec4 #aeja4 ,short title4 ,sec4 #aejb4 ,,fda opioid action plan4 ,sec4 #aejc4 ,prescriber education4 ,sec4 #aejd4 ,guidance on evaluating the abuse deterrence of generic solid oral opioid drug products4 ,title ,,xvi--,examining ,opioid ,treatment ,infrastructure ,act ,sec4 #afja4 ,short title4 ,sec4 #afjb4 ,study on treatment infrastructure4 ,title ,,xvii--,opioid ,use ,disorder ,treatment ,expansion and ,modernization ,act ,sec4 #agja4 ,short title4 ,sec4 #agjb4 ,finding4 ,sec4 #agjc4 ,opioid use disorder treatment modernization4 ,sec4 #agjd4 ,sense of ,congress4 ,sec4 #agje4 ,partial fills of schedule ,,ii controlled substances4 ,title ,,xviii--,national ,all ,schedules ,prescription ,electronic ,reporting ,reauthorization ,act ,sec4 #ahja4 ,short title4 ,sec4 #ahjb4 ,amendment to purpose4 ,sec4 #ahjc4 ,amendments to controlled substance monitoring program4 ,i ,pain ,management ,best ,practices ,inter-,agency ,task ,force #aja4 ,development of best practices for the use of prescription opioids 7a7 ,definitions ,in this section-- 7#a7 the term ,secretary means the ,secretary of ,health and ,human ,services2 and 7#b7 the term task force means the ,pain ,management ,best ,practices ,inter-,agency ,task ,force convened under subsection 7b74 7b7 ,inter-,agency ,task ,force ,not later than ,december #ad1 #bjah1 the ,secretary1 in cooperation with the ,secretary of ,veterans ,affairs1 the ,secretary of ,defense1 and the ,administrator of the ,drug ,enforcement ,administration1 shall convene a ,pain ,management ,best ,practices ,inter-,agency ,task ,force to review1 modify1 and update1 as appropriate1 best practices for pain management 7including chronic and acute pain7 and prescribing pain medication4 7c7 ,membership ,the task force shall be comprised of-- 7#a7 representatives of-- 7,a7 the ,department of ,health and ,human ,services2 7,b7 the ,department of ,veterans ,affairs2 7,c7 the ,food and ,drug ,administration2 7,d7 the ,department of ,defense2 7,e7 the ,drug ,enforcement ,administration2 7,f7 the ,centers for ,disease ,control and ,prevention2 7,g7 the ,health ,resources and ,services ,administration2 7,h7 the ,indian ,health ,service2 7,i7 the ,national ,academy of ,medicine2 7,j7 the ,national ,institutes of ,health2 7,k7 the ,office of ,national ,drug ,control ,policy2 7,l7 the ,substance ,abuse and ,mental ,health ,services ,administration2 and 7,m7 the ,office of ,women's ,health2 7#b7 ,state medical boards2 7#c7 subject to subsection 7e71 physicians1 dentists1 and nonphysician prescribers2 7#d7 hospitals2 7#e7 subject to subsection 7e71 pharmacists and pharmacies2 7#f7 first responders2 7#g7 experts in the fields of pain research and addiction research2 7#h7 experts in the fields of adolescent and young adult addiction research2 7#i7 representatives of-- 7,a7 pain management professional organizations2 7,b7 the mental health treatment community2 7,c7 the addiction treatment and recovery community2 7,d7 pain advocacy groups2 7,e7 veteran service organizations2 and 7,f7 groups with expertise on overdose reversal2 7#aj7 a person in recovery from addiction to medication for chronic pain2 7#aa7 a person in recovery from addiction to medication for chronic pain1 whose addiction began in adolescence or young adulthood2 7#ab7 a person with chronic pain2 7#ac7 an expert on active duty military1 armed forces personnel1 and veteran health and prescription opioid addiction2 7#ad7 an expert in the field of minority health2 and 7#ae7 other stakeholders1 as the ,secretary determines appropriate4 7d7 ,condition on participation on task force ,an individual representing a profession or entity described in paragraph 7#c7 or 7#e7 of subsection 7c7 may not serve as a member of the task force unless such individual-- 7#a7 is currently licensed in a ,state in which such individual is practicing 7as defined by such ,state7 such profession 7or1 in the case of an individual representing an entity1 a ,state in which the entity is engaged in business72 and 7#b7 is currently practicing 7as defined by such ,state7 such profession 7or1 in the case of an individual representing an entity1 the entity is in operation74 7e7 ,duties ,the task force shall-- 7#a7 not later than #ahj days after the date on which the task force is convened under subsection 7b71 review1 modify1 and update1 as appropriate1 best practices for pain management 7including chronic and acute pain7 and prescribing pain medication1 taking into consideration-- 7,a7 existing pain management research2 7,b7 research on trends in areas and communities in which the prescription opioid abuse rate and fatality rate exceed the national average prescription opioid abuse rate and fatality rate2 7,c7 recommendations from relevant conferences and existing relevant evidence-based guidelines2 7,d7 ongoing efforts at the ,state and local levels and by medical professional organizations to develop improved pain management strategies1 including consideration of differences within and between classes of opioids1 the availability of opioids with abuse deterrent technology1 and pharmacological1 nonpharmacological1 medical device alternatives to opioids to reduce opioid monotherapy in appropriate cases and the coordination of information collected from ,state prescription drug monitoring programs for the purpose of preventing the diversion of pain medication2 7,e7 ongoing efforts at the ,federal1 ,state1 and local levels to examine the potential benefits of electronic prescribing of opioids1 including any public comments collected in the course of those efforts2 7,f7 the management of high-risk populations1 other than populations who suffer pain1 who-- 7i7 may use or be prescribed benzodiazepines1 alcohol1 and diverted opioids2 or 7ii7 receive opioids in the course of medical care2 7,g7 the distinct needs of adolescents and young adults with respect to pain management1 pain medication1 substance use disorder1 and medication-assisted treatment2 7,h7 the #bjaf ,guideline for ,prescribing ,opioids for ,chronic ,pain issued by the ,centers for ,disease ,control and ,prevention2 7,i7 the practice of co-prescribing naloxone for both pain patients receiving chronic opioid therapy and patients being treated for opioid use disorders2 7,j7 research that has been1 or is being1 conducted or supported by the ,federal ,government on prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults relative to any unique circumstances 7including social and biological circumstances7 of adolescents and young adults that may make adolescent-specific and young adult-specific treatment protocols necessary1 including any effects that substance use and substance use disorders may have on brain development and the implications for treatment and recovery2 7,k7 ,federal non-research programs and activities that address prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults1 including an assessment of the effectiveness of such programs and activities in-- 7i7 preventing substance use by and substance use disorders among adolescents and young adults2 7ii7 treating such adolescents and young adults in a way that accounts for any unique circumstances faced by adolescents and young adults2 and 7iii7 supporting long-term recovery among adolescents and young adults2 and 7,l7 gaps that have been identified by ,federal officials and experts in ,federal efforts relating to prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults1 including gaps in research1 data collection1 and measures to evaluate the effectiveness of ,federal efforts1 and the reasons for such gaps2 7#b7 solicit and take into consideration public comment on the practices developed under paragraph 7#a71 amending such best practices if appropriate2 7#c7 develop a strategy for disseminating information about the best practices developed under paragraphs 7#a7 and 7#b7 to prescribers1 pharmacists1 ,state medical boards1 educational institutions that educate prescribers and pharmacists1 and other parties1 as the ,secretary determines appropriate2 7#d7 review1 modify1 and update best practices for pain management and prescribing pain medication1 specifically as it pertains to physician education and consumer education2 and 7#e7 examine and identify-- 7,a7 the extent of the need for the development of new pharmacological1 nonpharmacological1 and medical device alternatives to opioids2 7,b7 the current status of research efforts to develop such alternatives2 and 7,c7 the pharmacological1 nonpharmacological1 and medical device alternatives to opioids that are currently available that could be better utilized4 7f7 ,consideration of study results ,in reviewing1 modifying1 and updating1 best practices for pain management and prescribing pain medication1 the task force shall take into consideration existing private sector1 ,state1 and local government efforts related to pain management and prescribing pain medication4 7g7 ,limitation ,the task force shall not have rulemaking authority4 7h7 ,report ,not later than #bgj days after the date on which the task force is convened under subsection 7b71 the task force shall submit to ,congress a report that includes-- 7#a7 the strategy for disseminating best practices for pain management 7including chronic and acute pain7 and prescribing pain medication1 as developed under subsection 7e72 7#b7 the results of a feasibility study on linking the best practices described in paragraph 7#a7 to receiving and renewing registrations under section #cjc7;f7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;f772 7#c7 recommendations for effectively applying the best practices described in paragraph 7#a7 to improve prescribing practices at medical facilities1 including medical facilities of the ,veterans ,health ,administration and ,indian ,health ,service2 7#d7 the modified and updated best practices described in subsection 7e77#d72 and 7#e7 the results of the examination and identification conducted pursuant to subsection 7e77#d71 and recommendations regarding-- 7,a7 the development of new pharmacological1 nonpharmacological1 and medical device alternatives to opioids2 and 7,b7 the improved utilization of pharmacological1 nonpharmacological1 and medical device alternatives to opioids that are currently available4 ,,ii ,comprehensive ,opioid ,abuse ,reduction ,act #bja4 ,short title ,this title may be cited as the ,comprehensive ,opioid ,abuse ,reduction ,act of #bjaf4 #bjb4 ,comprehensive ,opioid ,abuse ,grant ,program 7a7 ,in general ,title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#db ,u4,s4,c4 #cgaa et seq47 is amended by adding at the end the following3 ,,ll ,comprehensive ,opioid ,abuse ,grant ,program #cjba4 ,description 7a7 ,grants authorized ,from amounts made available to carry out this part1 the ,attorney ,general may make grants to ,states1 units of local government1 and ,indian tribes1 for use by the ,state1 unit of local government1 or ,indian tribe to provide services primarily relating to opioid abuse1 including for any one or more of the following3 7#a7 ,developing1 implementing1 or expanding a treatment alternative to incarceration program1 which may include-- 7,a7 pre-booking or post-booking components1 which may include the activities described in part ,,dd or ,,hh of this title2 7,b7 training for criminal justice agency personnel on substance use disorders and co-occurring mental illness and substance use disorders2 7,c7 a mental health court1 including the activities described in part ,v of this title2 7,d7 a drug court1 including the activities described in part ,,ee of this title2 7,e7 a veterans treatment court program1 including the activities described in subsection 7i7 of section #biia of this title2 7,f7 a focus on parents whose incarceration could result in their children entering the child welfare system2 and 7,g7 a community-based substance use diversion program sponsored by a law enforcement agency4 7#b7 ,in the case of a ,state1 facilitating or enhancing planning and collaboration between ,state criminal justice agencies and ,state substance abuse systems in order to more efficiently and effectively carry out programs described in paragraph 7#a7 that address problems related to opioid abuse4 7#c7 ,providing training and resources for first responders on carrying and administering an opioid overdose reversal drug or device approved by the ,food and ,drug ,administration1 and purchasing such a drug or device for first responders who have received such training to carry and administer4 7#d7 ,investigative purposes to locate or investigate illicit activities related to the unlawful distribution of opioids4 7#e7 ,developing1 implementing1 or expanding a medication-assisted treatment program used or operated by a criminal justice agency1 which may include training criminal justice agency personnel on medication-assisted treatment1 and carrying out the activities described in part ,s of this title4 7#f7 ,in the case of a ,state1 developing1 implementing1 or expanding a prescription drug monitoring program to collect and analyze data related to the prescribing of schedules ,,ii1 ,,iii1 and ,,iv controlled substances through a centralized database administered by an authorized ,state agency1 which includes tracking the dispensation of such substances1 and providing for interoperability and data sharing with other ,states4 7#g7 ,developing1 implementing1 or expanding a program to prevent and address opioid abuse by juveniles4 7#h7 ,developing1 implementing1 or expanding an integrated and comprehensive opioid abuse response program1 including prevention and recovery programs4 7#i7 ,developing1 implementing1 or expanding a program 7which may include demonstration projects7 to utilize technology that provides a secure container for prescription drugs that would prevent individuals1 particularly adolescents1 from gaining access to opioid medications that are lawfully prescribed for other individuals4 7#aj7 ,developing1 implementing1 or expanding a program to prevent and address opioid abuse by veterans4 7#aa7 ,developing1 implementing1 or expanding a prescription drug take-back program4 7b7 ,contracts and subawards ,a ,state1 unit of local government1 or ,indian tribe may1 in using a grant under this subpart for purposes authorized by subsection 7a71 use all or a portion of that grant to contract with or make one or more subawards to one or more-- 7#a7 local or regional organizations that are private and nonprofit1 including faith-based organizations2 7#b7 units of local government2 or 7#c7 tribal organizations4 7c7 ,program ,assessment ,component2 ,waiver 7#a7 ,program ,assessment ,component ,each program funded under this subpart shall contain a program assessment component1 developed pursuant to guidelines established by the ,attorney ,general1 in coordination with the ,national ,institute of ,justice4 7#b7 ,waiver ,the ,attorney ,general may waive the requirement of paragraph 7#a7 with respect to a program if1 in the opinion of the ,attorney ,general1 the program is not of sufficient size to justify a full program assessment4 7d7 ,administrative costs ,not more than #aj percent of a grant made under this subpart may be used for costs incurred to administer such grant4 7e7 ,period ,the period of a grant made under this part may not be longer than #d years1 except that renewals and extensions beyond that period may be granted at the discretion of the ,attorney ,general4 #cjbb4 ,applications ,to request a grant under this part1 the chief executive officer of a ,state1 unit of local government1 or ,indian tribe shall submit an application to the ,attorney ,general at such time and in such form as the ,attorney ,general may require4 ,such application shall include the following3 7#a7 ,a certification that ,federal funds made available under this subpart will not be used to supplant ,state1 local1 or tribal funds1 but will be used to increase the amounts of such funds that would1 in the absence of ,federal funds1 be made available for the activities described in section #cjba7;a74 7#b7 ,an assurance that1 for each fiscal year covered by an application1 the applicant shall maintain and report such data1 records1 and information 7programmatic and financial7 as the ,attorney ,general may reasonably require4 7#c7 ,a certification1 made in a form acceptable to the ,attorney ,general and executed by the chief executive officer of the applicant 7or by another officer of the applicant1 if qualified under regulations promulgated by the ,attorney ,general71 that-- 7,a7 the programs to be funded by the grant meet all the requirements of this part2 7,b7 all the information contained in the application is correct2 7,c7 there has been appropriate coordination with affected agencies2 and 7,d7 the applicant will comply with all provisions of this part and all other applicable ,federal laws4 7#d7 ,an assurance that the applicant will work with the ,drug ,enforcement ,administration to develop an integrated and comprehensive strategy to address opioid abuse4 #cjbc4 ,review of applications ,the ,attorney ,general shall not finally disapprove any application 7or any amendment to that application7 submitted under this part without first affording the applicant reasonable notice of any deficiencies in the application and opportunity for correction and reconsideration4 #cjbd4 ,equitable distribution of funds ,in awarding grants under this part1 the ,attorney ,general shall ensure equitable distribution of funds based on the following3 7#a7 ,the geographic distribution of grants under this part1 taking into consideration the needs of underserved populations1 including rural and tribal communities4 7#b7 ,the needs of communities to address the problems related to opioid abuse1 taking into consideration the prevalence of opioid abuse and overdose-related death in a community4 #cjbe4 ,definitions ,in this part3 7#a7 ,the term first responder includes a firefighter1 law enforcement officer1 paramedic1 emergency medical technician1 or other individual 7including an employee of a legally organized and recognized volunteer organization1 whether compensated or not71 who1 in the course of professional duties1 responds to fire1 medical1 hazardous material1 or other similar emergencies4 7#b7 ,the term medication-assisted treatment means the use of medications approved by the ,food and ,drug ,administration for the treatment of opioid abuse4 7#c7 ,the term opioid means any drug1 including heroin1 having an addiction-forming or addiction-sustaining liability similar to morphine or being capable of conversion into a drug having such addiction-forming or addiction-sustaining liability4 7#d7 ,the term schedule ,,ii1 ,,iii1 or ,,iv controlled substance means a controlled substance that is listed on schedule ,,ii1 schedule ,,iii1 or schedule ,,iv of section #bjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7;c774 7#e7 ,the terms drug and device have the meanings given those terms in section #bja of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba74 7#f7 ,the term criminal justice agency means a ,state1 local1 or tribal-- 7,a7 court2 7,b7 prison2 7,c7 jail2 7,d7 law enforcement agency2 or 7,e7 other agency that performs the administration of criminal justice1 including prosecution1 pretrial services1 and community supervision4 7#g7 ,the term tribal organization has the meaning given that term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #dej;b74 4 7b7 ,authorization of appropriations ,section #ajja7;a7 of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#db ,u4,s4,c4 #cgic7;a77 is amended by inserting after paragraph 7#bf7 the following3 7#bg7 ,there are authorized to be appropriated to carry out part ,,ll #ajc1jjj1jjj for each of fiscal years #bjag through #bjba4 4 #bjc4 ,audit and accountability of grantees 7a7 ,definitions ,in this section-- 7#a7 the term covered grant program means a grant program operated by the ,department of ,justice2 7#b7 the term covered grantee means a recipient of a grant from a covered grant program2 7#c7 the term nonprofit1 when used with respect to an organization1 means an organization that is described in section #eja7;c77#c7 of the ,internal ,revenue ,code of #aihf1 and is exempt from taxation under section #eja7;a7 of such ,code2 and 7#d7 the term unresolved audit finding means an audit report finding in a final audit report of the ,inspector ,general of the ,department of ,justice that a covered grantee has used grant funds awarded to that grantee under a covered grant program for an unauthorized expenditure or otherwise unallowable cost that is not closed or resolved during a #ab-month period prior to the date on which the final audit report is issued4 7b7 ,audit requirement ,beginning in fiscal year #bjaf1 and annually thereafter1 the ,inspector ,general of the ,department of ,justice shall conduct audits of covered grantees to prevent waste1 fraud1 and abuse of funds awarded under covered grant programs4 ,the ,inspector ,general shall determine the appropriate number of covered grantees to be audited each year4 7c7 ,mandatory exclusion ,a grantee that is found to have an unresolved audit finding under an audit conducted under subsection 7b7 may not receive grant funds under a covered grant program in the fiscal year following the fiscal year to which the finding relates4 7d7 ,reimbursement ,if a covered grantee is awarded funds under the covered grant program from which it received a grant award during the #a-;fiscal-year period during which the covered grantee is ineligible for an allocation of grant funds under subsection 7c71 the ,attorney ,general shall-- 7#a7 deposit into the ,general ,fund of the ,treasury an amount that is equal to the amount of the grant funds that were improperly awarded to the covered grantee2 and 7#b7 seek to recoup the costs of the repayment to the ,fund from the covered grantee that was improperly awarded the grant funds4 7e7 ,priority of grant awards ,the ,attorney ,general1 in awarding grants under a covered grant program shall give priority to eligible entities that during the #b-year period preceding the application for a grant have not been found to have an unresolved audit finding4 7f7 ,nonprofit requirements 7#a7 ,prohibition ,a nonprofit organization that holds money in offshore accounts for the purpose of avoiding the tax described in section #eaa7;a7 of the ,internal ,revenue ,code of #aihf1 shall not be eligible to receive1 directly or indirectly1 any funds from a covered grant program4 7#b7 ,disclosure ,each nonprofit organization that is a covered grantee shall disclose in its application for such a grant1 as a condition of receipt of such a grant1 the compensation of its officers1 directors1 and trustees4 ,such disclosure shall include a description of the criteria relied on to determine such compensation4 #bjd4 ,veterans treatment courts ,section #biia of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#db ,u4,s4,c4 #cgig;aa7 is amended-- 7#a7 by redesignating subsection 7i7 as subsection 7j72 and 7#b7 by inserting after subsection 7h7 the following3 7i7 ,assisting veterans 7#a7 ,definitions ,in this subsection3 7,a7 ,peer to peer services or programs ,the term peer to peer services or programs means services or programs that connect qualified veterans with other veterans for the purpose of providing support and mentorship to assist qualified veterans in obtaining treatment1 recovery1 stabilization1 or rehabilitation4 7,b7 ,qualified veteran ,the term qualified veteran means a preliminarily qualified offender who-- 7i7 served on active duty in any branch of the ,armed ,forces1 including the ,national ,guard or ,reserves2 and 7ii7 was discharged or released from such service under conditions other than dishonorable4 7,c7 ,veterans treatment court program ,the term veterans treatment court program means a court program involving collaboration among criminal justice1 veterans1 and mental health and substance abuse agencies that provides qualified veterans with-- 7i7 intensive judicial supervision and case management1 which may include random and frequent drug testing where appropriate2 7ii7 a full continuum of treatment services1 including mental health services1 substance abuse services1 medical services1 and services to address trauma2 7iii7 alternatives to incarceration2 or 7iv7 other appropriate services1 including housing1 transportation1 mentoring1 employment1 job training1 education1 or assistance in applying for and obtaining available benefits4 7#b7 ,veterans assistance program 7,a7 ,in general ,the ,attorney ,general1 in consultation with the ,secretary of ,veterans ,affairs1 may award grants under this subsection to applicants to establish or expand-- 7i7 veterans treatment court programs2 7ii7 peer to peer services or programs for qualified veterans2 7iii7 practices that identify and provide treatment1 rehabilitation1 legal1 transitional1 and other appropriate services to qualified veterans who have been incarcerated2 or 7iv7 training programs to teach criminal justice1 law enforcement1 corrections1 mental health1 and substance abuse personnel how to identify and appropriately respond to incidents involving qualified veterans4 7,b7 ,priority ,in awarding grants under this subsection1 the ,attorney ,general shall give priority to applications that-- 7i7 demonstrate collaboration between and joint investments by criminal justice1 mental health1 substance abuse1 and veterans service agencies2 7ii7 promote effective strategies to identify and reduce the risk of harm to qualified veterans and public safety2 and 7iii7 propose interventions with empirical support to improve outcomes for qualified veterans4 4 #bje4 ,emergency ,federal law enforcement assistance ,section #fji,y7a7 of the ,justice ,assistance ,act of #aihd 7#db ,u4,s4,c4 #ajeac7;a77 is amended by striking ,september #cj1 #aihd and inserting ,september #cj1 #bjba4 #bjf4 ,inclusion of services for pregnant women under family-based substance abuse grants ,part ,,dd of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act 7#db ,u4,s4,c4 #cgigs et seq47 is amended-- 7#a7 in section #biba7b71 by inserting before the period at the end or pregnant women2 and 7#b7 in section #bibg-- 7,a7 in paragraph 7#a77;,a71 by inserting pregnant or before a parent2 and 7,b7 in paragraph 7#c71 by inserting or pregnant women after incarcerated parents4 #bjg4 ,,gao study and report on ,department of ,justice programs and research relative to substance use and substance use disorders among adolescents and young adults 7a7 ,study ,the ,comptroller ,general of the ,united ,states shall conduct a study on how the ,department of ,justice1 through grant programs1 is addressing prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults4 ,such study shall include an analysis of each of the following3 7#a7 ,the research that has been1 and is being1 conducted or supported pursuant to grant programs operated by the ,department of ,justice on prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults1 including an assessment of-- 7,a7 such research relative to any unique circumstances 7including social and biological circumstances7 of adolescents and young adults that may make adolescent-specific and young adult-specific treatment protocols necessary1 including any effects that substance use and substance use disorders may have on brain development and the implications for treatment and recovery2 and 7,b7 areas of such research in which greater investment or focus is necessary relative to other areas of such research4 7#b7 ,department of ,justice non-research programs and activities that address prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults1 including an assessment of the effectiveness of such programs and activities in preventing substance use by and substance use disorders among adolescents and young adults1 treating such adolescents and young adults in a way that accounts for any unique circumstances faced by adolescents and young adults1 and supports long term recovery among adolescents and young adults4 7#c7 ,gaps that have been identified by officials of the ,department of ,justice or experts in the efforts supported by grant programs operated by the ,department of ,justice relating to prevention of1 treatment for1 and recovery from substance use by and substance use disorders among adolescents and young adults1 including gaps in research1 data collection1 and measures to evaluate the effectiveness of such efforts1 and the reasons for such gaps4 7b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general shall submit to the appropriate committees of the ,congress a report containing the results of the study conducted under subsection 7a71 including-- 7#a7 a summary of the findings of the study2 and 7#b7 recommendations based on the results of the study1 including recommendations for such areas of research and legislative and administrative action as the ,comptroller ,general determines appropriate4 ,,iii ,jason ,simcakoski ,,promise ,act #cja4 ,short title ,this title may be cited as the ,promoting ,responsible ,opioid ,management and ,incorporating ,scientific ,expertise ,act or the ,jason ,simcakoski ,,promise ,act4 #cjb4 ,improvement of opioid safety measures by ,department of ,veterans ,affairs 7a7 ,expansion of opioid safety initiative 7#a7 ,inclusion of all medical facilities ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall expand the ,opioid ,safety ,initiative of the ,department of ,veterans ,affairs to include all medical facilities of the ,department4 7#b7 ,guidance ,the ,secretary shall establish guidance that each health care provider of the ,department of ,veterans ,affairs1 before initiating opioid therapy to treat a patient as part of the comprehensive assessment conducted by the health care provider1 use the ,opioid ,therapy ,risk ,report tool of the ,department of ,veterans ,affairs 7or any subsequent tool71 which shall include information from the prescription drug monitoring program of each participating ,state as applicable1 that includes the most recent information to date relating to the patient that accessed such program to assess the risk for adverse outcomes of opioid therapy for the patient1 including the concurrent use of controlled substances such as benzodiazepines1 as part of the comprehensive assessment conducted by the health care provider4 7#c7 ,enhanced standards ,the ,secretary shall establish enhanced standards with respect to the use of routine and random urine drug tests for all patients before and during opioid therapy to help prevent substance abuse1 dependence1 and diversion1 including-- 7,a7 that such tests occur not less frequently than once each year2 and 7,b7 that health care providers appropriately order1 interpret and respond to the results from such tests to tailor pain therapy1 safeguards1 and risk management strategies to each patient4 7b7 ,pain management education and training 7#a7 ,in general ,in carrying out the ,opioid ,safety ,initiative of the ,department1 the ,secretary shall require all employees of the ,department responsible for prescribing opioids to receive education and training described in paragraph 7#b74 7#b7 ,education and training ,education and training described in this paragraph is education and training on pain management and safe opioid prescribing practices for purposes of safely and effectively managing patients with chronic pain1 including education and training on the following3 7,a7 ,the implementation of and full compliance with the ,,va_/,,dod ,clinical ,practice ,guideline for ,management of ,opioid ,therapy for ,chronic ,pain1 including any update to such guideline4 7,b7 ,the use of evidence-based pain management therapies1 including cognitive-behavioral therapy1 non-opioid alternatives1 and non-drug methods and procedures to managing pain and related health conditions including medical devices approved or cleared by the ,food and ,drug ,administration for the treatment of patients with chronic pain and complementary alternative medicines4 7,c7 ,screening and identification of patients with substance use disorder1 including drug-seeking behavior1 before prescribing opioids1 assessment of risk potential for patients developing an addiction1 and referral of patients to appropriate addiction treatment professionals if addiction is identified or strongly suspected4 7,d7 ,communication with patients on the potential harm associated with the use of opioids and other controlled substances1 including the need to safely store and dispose of supplies relating to the use of opioids and other controlled substances4 7,e7 ,such other education and training as the ,secretary considers appropriate to ensure that veterans receive safe and high-quality pain management care from the ,department4 7#c7 ,use of existing program ,in providing education and training described in paragraph 7#b71 the ,secretary shall use the ,interdisciplinary ,chronic ,pain ,management ,training ,team ,program of the ,department 7or success program74 7c7 ,pain management teams 7#a7 ,in general ,in carrying out the ,opioid ,safety ,initiative of the ,department1 the director of each medical facility of the ,department shall identify and designate a pain management team of health care professionals1 which may include board certified pain medicine specialists1 responsible for coordinating and overseeing pain management therapy at such facility for patients experiencing acute and chronic pain that is non-cancer related4 7#b7 ,establishment of protocols 7,a7 ,in general ,in consultation with the ,directors of each ,veterans ,integrated ,service ,network1 the ,secretary shall establish standard protocols for the designation of pain management teams at each medical facility within the ,department4 7,b7 ,consultation on prescription of opioids ,each protocol established under subparagraph 7,a7 shall ensure that any health care provider without expertise in prescribing analgesics or who has not completed the education and training under subsection 7b71 including a mental health care provider1 does not prescribe opioids to a patient unless that health care provider-- 7i7 consults with a health care provider with pain management expertise or who is on the pain management team of the medical facility2 and 7ii7 refers the patient to the pain management team for any subsequent prescriptions and related therapy4 7#c7 ,report 7,a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the director of each medical facility of the ,department shall submit to the ,under ,secretary for ,health and the director of the ,veterans ,integrated ,service ,network in which the medical facility is located a report identifying the health care professionals that have been designated as members of the pain management team at the medical facility pursuant to paragraph 7#a74 7,b7 ,elements ,each report submitted under subparagraph 7,a7 with respect to a medical facility of the ,department shall include-- 7i7 a certification as to whether all members of the pain management team at the medical facility have completed the education and training required under subsection 7b72 7ii7 a plan for the management and referral of patients to such pain management team if health care providers without expertise in prescribing analgesics prescribe opioid medications to treat acute and chronic pain that is non-cancer related2 and 7iii7 a certification as to whether the medical facility-- 7,i7 fully complies with the stepped-care model of pain management and other pain management policies contained in ,directive #bjji-jec of the ,veterans ,health ,administration1 or successor directive2 or 7,,ii7 does not fully comply with such stepped-care model of pain management and other pain management policies but is carrying out a corrective plan of action to ensure such full compliance4 7d7 ,tracking and monitoring of opioid use 7#a7 ,prescription drug monitoring programs of states ,in carrying out the ,opioid ,safety ,initiative and the ,opioid ,therapy ,risk ,report tool of the ,department1 the ,secretary shall-- 7,a7 ensure access by health care providers of the ,department to information on controlled substances1 including opioids and benzodiazepines1 prescribed to veterans who receive care outside the ,department through the prescription drug monitoring program of each ,state with such a program1 including by seeking to enter into memoranda of understanding with ,states to allow shared access of such information between ,states and the ,department2 7,b7 include such information in the ,opioid ,therapy ,risk ,report2 and 7,c7 require health care providers of the ,department to submit to the prescription drug monitoring program of each ,state information on prescriptions of controlled substances received by veterans in that ,state under the laws administered by the ,secretary4 7#b7 ,report on tracking of data on opioid use ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the feasibility and advisability of improving the ,opioid ,therapy ,risk ,report tool of the ,department to allow for more advanced real-time tracking of and access to data on-- 7,a7 the key clinical indicators with respect to the totality of opioid use by veterans2 7,b7 concurrent prescribing by health care providers of the ,department of opioids in different health care settings1 including data on concurrent prescribing of opioids to treat mental health disorders other than opioid use disorder2 and 7,c7 mail-order prescriptions of opioid prescribed to veterans under the laws administered by the ,secretary4 7e7 ,availability of opioid receptor antagonists 7#a7 ,increased availability and use 7,a7 ,in general ,the ,secretary shall maximize the availability of opioid receptor antagonists approved by the ,food and ,drug ,administration1 including naloxone1 to veterans4 7,b7 ,availability1 training1 and distributing ,in carrying out subparagraph 7,a71 not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall-- 7i7 equip each pharmacy of the ,department with opioid receptor antagonists approved by the ,food and ,drug ,administration to be dispensed to outpatients as needed2 and 7ii7 expand the ,overdose ,education and ,naloxone ,distribution program of the ,department to ensure that all veterans in receipt of health care under laws administered by the ,secretary who are at risk of opioid overdose may access such opioid receptor antagonists and training on the proper administration of such opioid receptor antagonists4 7,c7 ,veterans who are at risk ,for purposes of subparagraph 7,b71 veterans who are at risk of opioid overdose include-- 7i7 veterans receiving long-term opioid therapy2 7ii7 veterans receiving opioid therapy who have a history of substance use disorder or prior instances of overdose2 and 7iii7 veterans who are at risk as determined by a health care provider who is treating the veteran4 7#b7 ,report ,not later than #abj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on carrying out paragraph 7#a71 including an assessment of any remaining steps to be carried out by the ,secretary to carry out such paragraph4 7f7 ,inclusion of certain information and capabilities in opioid therapy risk report tool of the ,department 7#a7 ,information ,the ,secretary shall include in the ,opioid ,therapy ,risk ,report tool of the ,department-- 7,a7 information on the most recent time the tool was accessed by a health care provider of the ,department with respect to each veteran2 and 7,b7 information on the results of the most recent urine drug test for each veteran4 7#b7 ,capabilities ,the ,secretary shall include in the ,opioid ,therapy ,risk ,report tool the ability of the health care providers of the ,department to determine whether a health care provider of the ,department prescribed opioids to a veteran without checking the information in the tool with respect to the veteran4 7g7 ,notifications of risk in computerized health record ,the ,secretary shall modify the computerized patient record system of the ,department to ensure that any health care provider that accesses the record of a veteran1 regardless of the reason the veteran seeks care from the health care provider1 will be immediately notified whether the veteran-- 7#a7 is receiving opioid therapy and has a history of substance use disorder or prior instances of overdose2 7#b7 has a history of opioid abuse2 or 7#c7 is at risk of becoming an opioid abuser as determined by a health care provider who is treating the veteran4 7h7 ,definitions ,in this section3 7#a7 ,the term controlled substance has the meaning given that term in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,the term ,state means each of the several ,states1 territories1 and possessions of the ,united ,states1 the ,district of ,columbia1 and the ,commonwealth of ,puerto ,rico4 #cjc4 ,strengthening of joint working group on pain management of the ,department of ,veterans ,affairs and the ,department of ,defense 7a7 ,in general ,not later than #ij days after the date of enactment of this ,act1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall ensure that the ,pain ,management ,working ,group of the ,health ,executive ,committee of the ,department of ,veterans ,affairs-,department of ,defense ,joint ,executive ,committee 7,pain ,management ,working ,group7 established under section #cbj of title #ch1 ,united ,states ,code1 includes a focus on the following3 7#a7 ,the opioid prescribing practices of health care providers of each ,department4 7#b7 ,the ability of each ,department to manage acute and chronic pain among individuals receiving health care from the ,department1 including training health care providers with respect to pain management4 7#c7 ,the use by each ,department of complementary and integrative health and complementary alternative medicines in treating such individuals4 7#d7 ,the concurrent use by health care providers of each ,department of opioids and prescription drugs to treat mental health disorders1 including benzodiazepines4 7#e7 ,the practice by health care providers of each ,department of prescribing opioids to treat mental health disorders4 7#f7 ,the coordination in coverage of and consistent access to medications prescribed for patients transitioning from receiving health care from the ,department of ,defense to receiving health care from the ,department of ,veterans ,affairs4 7#g7 ,the ability of each ,department to identify and treat substance use disorders among individuals receiving health care from that ,department4 7b7 ,coordination and consultation ,the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall ensure that the working group described in subsection 7a7-- 7#a7 coordinates the activities of the working group with other relevant working groups established under section #cbj of title #ch1 ,united ,states ,code2 7#b7 consults with other relevant ,federal agencies with respect to the activities of the working group2 and 7#c7 consults with the ,department of ,veterans ,affairs and the ,department of ,defense with respect to1 reviews1 and comments on the ,,va_/,,dod ,clinical ,practice ,guideline for ,management of ,opioid ,therapy for ,chronic ,pain1 or any successor guideline1 before any update to the guideline is released4 7c7 ,clinical practice guidelines 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall issue an update to the ,,va_/,,dod ,clinical ,practice ,guideline for ,management of ,opioid ,therapy for ,chronic ,pain4 7#b7 ,matters included ,in conducting the update under subsection 7a71 the ,pain ,management ,working ,group1 in coordination with the ,clinical ,practice ,guideline ,,va_/,,dod ,management of ,opioid ,therapy for ,chronic ,pain ,working ,group1 shall examine whether the ,clinical ,practical ,guideline should include the following3 7,a7 ,enhanced guidance with respect to-- 7i7 the coadministration of an opioid and other drugs1 including benzodiazepines1 that may result in life-limiting drug interactions2 7ii7 the treatment of patients with current acute psychiatric instability or substance use disorder or patients at risk of suicide2 and 7iii7 the use of opioid therapy to treat mental health disorders other than opioid use disorder4 7,b7 ,enhanced guidance with respect to the treatment of patients with behaviors or comorbidities1 such as post-traumatic stress disorder or other psychiatric disorders1 or a history of substance abuse or addiction1 that requires a consultation or comanagement of opioid therapy with one or more specialists in pain management1 mental health1 or addictions4 7,c7 ,enhanced guidance with respect to health care providers-- 7i7 conducting an effective assessment for patients beginning or continuing opioid therapy1 including understanding and setting realistic goals with respect to achieving and maintaining an expected level of pain relief1 improved function1 or a clinically appropriate combination of both2 and 7ii7 effectively assessing whether opioid therapy is achieving or maintaining the established treatment goals of the patient or whether the patient and health care provider should discuss adjusting1 augmenting1 or discontinuing the opioid therapy4 7,d7 ,guidelines to govern the methodologies used by health care providers of the ,department of ,veterans ,affairs and the ,department of ,defense to taper opioid therapy when adjusting or discontinuing the use of opioid therapy4 7,e7 ,guidelines with respect to appropriate case management for patients receiving opioid therapy who transition between inpatient and outpatient health care settings1 which may include the use of care transition plans4 7,f7 ,guidelines with respect to appropriate case management for patients receiving opioid therapy who transition from receiving care during active duty to post-military health care networks4 7,g7 ,guidelines with respect to providing options1 before initiating opioid therapy1 for pain management therapies without the use of opioids and options to augment opioid therapy with other clinical and complementary and integrative health services to minimize opioid dependence4 7,h7 ,guidelines with respect to the provision of evidence-based non-opioid treatments within the ,department of ,veterans ,affairs and the ,department of ,defense1 including medical devices and other therapies approved or cleared by the ,food and ,drug ,administration for the treatment of chronic pain as an alternative to or to augment opioid therapy4 #cjd4 ,review1 investigation1 and report on use of opioids in treatment by ,department of ,veterans ,affairs 7a7 ,comptroller general report 7#a7 ,in general ,not later than #b years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the ,opioid ,safety ,initiative of the ,department of ,veterans ,affairs and the opioid prescribing practices of health care providers of the ,department4 7#b7 ,elements ,the report submitted under paragraph 7#a7 shall include the following3 7,a7 ,recommendations on such improvements to the ,opioid ,safety ,initiative of the ,department as the ,comptroller ,general considers appropriate4 7,b7 ,information with respect to-- 7i7 deaths resulting from sentinel events involving veterans prescribed opioids by a health care provider of the ,department2 7ii7 overall prescription rates and prescriptions indications of opioids to treat non-cancer1 non-palliative1 and non-hospice care patients2 7iii7 the prescription rates and prescriptions indications of benzodiazepines and opioids concomitantly by health care providers of the ,department2 7iv7 the practice by health care providers of the ,department of prescribing opioids to treat patients without any pain1 including to treat patients with mental health disorders other than opioid use disorder2 and 7v7 the effectiveness of opioid therapy for patients receiving such therapy1 including the effectiveness of long-term opioid therapy4 7,c7 ,an evaluation of processes of the ,department in place to oversee opioid use among veterans1 including procedures to identify and remedy potential over-prescribing of opioids by health care providers of the ,department4 7,d7 ,an assessment of the implementation by the ,secretary of the ,,va_/,,dod ,clinical ,practice ,guideline for ,management of ,opioid ,therapy for ,chronic ,pain4 7b7 ,quarterly progress report on implementation of comptroller general recommendations ,not later than #b years after the date of the enactment of this ,act1 and not later than #cj days after the end of each quarter thereafter1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a progress report detailing the actions by the ,secretary during the period covered by the report to address any outstanding findings and recommendations by the ,comptroller ,general of the ,united ,states under subsection 7a7 with respect to the ,veterans ,health ,administration4 7c7 ,annual review of prescription rates ,not later than #a year after the date of the enactment of this ,act1 and not less frequently than annually for the following #e years1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report1 with respect to each medical facility of the ,department of ,veterans ,affairs1 to collect and review information on opioids prescribed by health care providers at the facility to treat non-cancer1 non-palliative1 and non-hospice care patients that contains1 for the #a-year period preceding the submission of the report1 the following3 7#a7 ,the number of patients and the percentage of the patient population of the ,department who were prescribed benzodiazepines and opioids concurrently by a health care provider of the ,department4 7#b7 ,the number of patients and the percentage of the patient population of the ,department without any pain who were prescribed opioids by a health care provider of the ,department1 including those who were prescribed benzodiazepines and opioids concurrently4 7#c7 ,the number of non-cancer1 non-palliative1 and non-hospice care patients and the percentage of such patients who were treated with opioids by a health care provider of the ,department on an inpatient-basis and who also received prescription opioids by mail from the ,department while being treated on an inpatient-basis4 7#d7 ,the number of non-cancer1 non-palliative1 and non-hospice care patients and the percentage of such patients who were prescribed opioids concurrently by a health care provider of the ,department and a health care provider that is not health care provider of the ,department4 7#e7 ,with respect to each medical facility of the ,department1 information on opioids prescribed by health care providers at the facility to treat non-cancer1 non-palliative1 and non-hospice care patients1 including information on-- 7,a7 the prescription rate at which each health care provider at the facility prescribed benzodiazepines and opioids concurrently to such patients and the aggregate such prescription rate for all health care providers at the facility2 7,b7 the prescription rate at which each health care provider at the facility prescribed benzodiazepines or opioids to such patients to treat conditions for which benzodiazepines or opioids are not approved treatment and the aggregate such prescription rate for all health care providers at the facility2 7,c7 the prescription rate at which each health care provider at the facility prescribed or dispensed mail-order prescriptions of opioids to such patients while such patients were being treated with opioids on an inpatient-basis and the aggregate of such prescription rate for all health care providers at the facility2 and 7,d7 the prescription rate at which each health care provider at the facility prescribed opioids to such patients who were also concurrently prescribed opioids by a health care provider that is not a health care provider of the ,department and the aggregate of such prescription rates for all health care providers at the facility4 7#f7 ,with respect to each medical facility of the ,department1 the number of times a pharmacist at the facility overrode a critical drug interaction warning with respect to an interaction between opioids and another medication before dispensing such medication to a veteran4 7d7 ,investigation of prescription rates ,if the ,secretary determines that a prescription rate with respect to a health care provider or medical facility of the ,department conflicts with or is otherwise inconsistent with the standards of appropriate and safe care1 the ,secretary shall-- 7#a7 immediately notify the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives of such determination1 including information relating to such determination1 prescription rate1 and health care provider or medical facility1 as the case may be2 and 7#b7 through the ,office of the ,medical ,inspector of the ,veterans ,health ,administration1 conduct a full investigation of the health care provider or medical facility1 as the case may be4 7e7 ,prescription rate defined ,in this section1 the term prescription rate means1 with respect to a health care provider or medical facility of the ,department1 each of the following3 7#a7 ,the number of patients treated with opioids by the health care provider or at the medical facility1 as the case may be1 divided by the total number of pharmacy users of that health care provider or medical facility4 7#b7 ,the average number of morphine equivalents per day prescribed by the health care provider or at the medical facility1 as the case may be1 to patients being treated with opioids4 7#c7 ,of the patients being treated with opioids by the health care provider or at the medical facility1 as the case may be1 the average number of prescriptions of opioids per patient4 #cje4 ,mandatory disclosure of certain veteran information to ,state controlled substance monitoring programs ,section #egja7l7 of title #ch1 ,united ,states ,code1 is amended by striking may and inserting shall4 #cjf4 ,modification to limitation on awards and bonuses ,section #gje of the ,veterans ,access1 ,choice1 and ,accountability ,act of #bjad 7,public ,law #aac-adf2 #ch ,u4,s4,c4 #gjc note7 is amended to read as follows3 #gje4 ,limitation on awards and bonuses paid to employees of ,department of ,veterans ,affairs ,the ,secretary of ,veterans ,affairs shall ensure that the aggregate amount of awards and bonuses paid by the ,secretary in a fiscal year under chapter #de or #ec of title #e1 ,united ,states ,code1 or any other awards or bonuses authorized under such title or title #ch1 ,united ,states ,code1 does not exceed the following amounts3 7#a7 ,with respect to each of fiscal years #bjag through #bjba1 #bcj1jjj1jjj4 7#b7 ,with respect to each of fiscal years #bjbb through #bjbd1 #cfj1jjj1jjj4 4 ,,iv ,kingpin ,designation ,improvement ,act #dja4 ,short title ,this title may be cited as the ,kingpin ,designation ,improvement ,act of #bjaf4 #djb4 ,protection of classified information in ,federal court challenges relating to designations under the ,narcotics ,kingpin ,designation ,act ,section #hjd of the ,foreign ,narcotics ,kingpin ,designation ,act 7#ba ,u4,s4,c4 #aijc7 is amended by adding at the end the following3 7i7 ,protection of classified information in ,federal court challenges relating to designations ,in any judicial review of a determination made under this section1 if the determination was based on classified information 7as defined in section #a7;a7 of the ,classified ,information ,procedures ,act7 such information may be submitted to the reviewing court ex parte and in camera4 ,this subsection does not confer or imply any right to judicial review4 4 ,v ,good ,samaritan ,assessment ,act #eja4 ,short title ,this title may be cited as the ,good ,samaritan ,assessment ,act of #bjaf4 #ejb4 ,finding ,the ,congress finds that the executive branch1 including the ,office of ,national ,drug ,control ,policy1 has a policy focus on preventing and addressing prescription drug misuse and heroin use1 and has worked with ,states and municipalities to enact ,good ,samaritan laws that would protect caregivers1 law enforcement personnel1 and first responders who administer opioid overdose reversal drugs or devices4 #ejc4 ,,gao ,study on ,good ,samaritan laws pertaining to treatment of opioid overdoses ,the ,comptroller ,general of the ,united ,states shall submit to the ,committee on the ,judiciary of the ,house of ,representatives1 the ,committee on ,oversight and ,government ,reform of the ,house of ,representatives1 the ,committee on the ,judiciary of the ,senate1 and the ,committee on ,homeland ,security and ,governmental ,affairs of the ,senate a report on-- 7#a7 the extent to which the ,director of ,national ,drug ,control ,policy has reviewed ,good ,samaritan laws1 and any findings from such a review1 including findings related to the potential effects of such laws1 if available2 7#b7 efforts by the ,director to encourage the enactment of ,good ,samaritan laws2 and 7#c7 a compilation of ,good ,samaritan laws in effect in the ,states1 the territories1 and the ,district of ,columbia4 #ejd4 ,definitions ,in this title-- 7#a7 the term ,good ,samaritan law means a law of a ,state or unit of local government that exempts from criminal or civil liability any individual who administers an opioid overdose reversal drug or device1 or who contacts emergency services providers in response to an overdose2 and 7#b7 the term opioid means any drug1 including heroin1 having an addiction-forming or addiction-sustaining liability similar to morphine or being capable of conversion into a drug having such addiction-forming or addiction-sustaining liability4 ,,vi ,,open ,act #fja4 ,short title ,this title may be cited as the ,opioid ,program ,evaluation ,act or the ,,open ,act4 #fjb4 ,evaluation of performance of ,department of ,justice program 7a7 ,evaluation of ,justice ,department ,comprehensive ,opioid ,abuse ,grant ,program ,not later than #e years after the date of enactment of this ,act1 the ,attorney ,general shall complete an evaluation of the effectiveness of the ,comprehensive ,opioid ,abuse ,grant ,program under part ,,ll of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh administered by the ,department of ,justice based upon the information reported under subsection 7d7 of this section4 7b7 ,interim evaluation ,not later than #c years after the date of enactment of this ,act1 the ,attorney ,general shall complete an interim evaluation assessing the nature and extent of the incidence of opioid abuse and illegal opioid distribution in the ,united ,states4 7c7 ,metrics and outcomes for evaluation ,not later than #ahj days after the date of enactment of this ,act1 the ,attorney ,general shall identify outcomes that are to be achieved by activities funded by the ,comprehensive ,opioid ,grant ,abuse ,program and the metrics by which the achievement of such outcomes shall be determined4 7d7 ,metrics data collection ,the ,attorney ,general shall require grantees under the ,comprehensive ,opioid ,abuse ,grant ,program 7and those receiving subawards under section #cjba7;b7 of part ,,ll of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh7 to collect and annually report to the ,department of ,justice data based upon the metrics identified under subsection 7c74 7e7 ,publication of data and findings 7#a7 ,publication of outcomes and metrics ,the ,attorney ,general shall1 not later than #cj days after completion of the requirement under subsection 7c71 publish the outcomes and metrics identified under that subsection4 7#b7 ,publication of evaluation ,in the case of the interim evaluation under subsection 7b71 and the final evaluation under subsection 7a71 the ,national ,academy of ,sciences shall1 not later than #ij days after such an evaluation is completed1 publish the results of such evaluation and issue a report on such evaluation to the ,committee on the ,judiciary of the ,house of ,representatives and the ,committee on the ,judiciary of the ,senate4 ,such report shall also be published along with the data used to make such evaluation4 7f7 ,arrangement with the ,national ,academy of ,sciences ,for purposes of subsections 7a71 7b71 and 7c71 the ,attorney ,general shall enter into an arrangement with the ,national ,academy of ,sciences4 #fjc4 ,evaluation of performance of ,department of ,health and ,human ,services program 7a7 ,evaluation of ,department of ,health and ,human ,services programs ,not later than #e years after the date of enactment of this ,act1 except as otherwise provided in this section1 the ,secretary of ,health and ,human ,services shall complete an evaluation of any program administered by the ,secretary that provides grants for the primary purpose of providing assistance in addressing problems pertaining to opioid abuse based upon the information reported under subsection 7d7 of this section4 7b7 ,interim evaluation ,not later than #c years after the date of enactment of this ,act1 the ,secretary shall complete an interim evaluation assessing the nature and extent of the incidence of opioid abuse and illegal opioid distribution in the ,united ,states4 7c7 ,metrics and outcomes for evaluation ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary shall identify outcomes that are to be achieved by activities funded by the programs described in subsection 7a7 and the metrics by which the achievement of such outcomes shall be determined4 7d7 ,metrics data collection ,the ,secretary shall require grantees under the programs described in subsection 7a7 to collect and annually report to the ,department of ,health and ,human ,services data based upon the metrics identified under subsection 7c74 7e7 ,publication of data and findings 7#a7 ,publication of outcomes and metrics ,the ,secretary shall1 not later than #cj days after completion of the requirement under subsection 7c71 publish the outcomes and metrics identified under that subsection4 7#b7 ,publication of evaluation ,in the case of the interim evaluation under subsection 7b71 and each final evaluation under subsection 7a71 the ,national ,academy of ,sciences shall1 not later than #ij days after such an evaluation is completed1 publish the results of such evaluation and issue a report on such evaluation to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate4 ,such report shall also be published along with the data used to make such evaluation4 7f7 ,arrangement with the ,national ,academy of ,sciences ,for purposes of subsections 7a71 7b71 and 7c71 the ,secretary shall-- 7#a7 enter into an arrangement with the ,national ,academy of ,sciences2 or 7#b7 enter into a contract or cooperative agreement with an entity that is not an agency of the ,federal ,government4 7g7 ,exception ,if a program described under subsection 7a7 is subject to an evaluation substantially similar to the evaluation under subsection 7a7 pursuant to another provision of law1 the ,secretary may opt not to conduct an evaluation under subsection 7a7 of such program4 #fjd4 ,definition ,in this title1 the term opioid has the meaning given the term opiate in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 #fje4 ,no additional funds authorized ,no additional funds are authorized to be appropriated to carry out this ,act4 #fjf4 ,matters regarding certain ,federal law enforcement assistance ,section #fji,y of the ,justice ,assistance ,act of #aihd 7#db ,u4,s4,c4 #ajeac7 is amended-- 7#a7 in subsection 7a71 by striking ,there is and inserting ,except as provided in subsection 7c71 there is2 and 7#b7 by adding at the end the following3 7c7 ,for fiscal year #bjbb1 there is authorized to be appropriated #af1jjj1jjj1 to provide under this chapter ,federal law enforcement assistance in the form of funds4 4 ,,vii ,infant ,plan of ,safe ,care ,improvement ,act #gja4 ,short title ,this title may be cited as the ,infant ,plan of ,safe ,care ,improvement ,act4 #gjb4 ,best practices for development of plans of safe care ,section #ajc7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajd7;b77 is amended-- 7#a7 by redesignating paragraphs 7#e7 through 7#h7 as paragraphs 7#f7 through 7#i71 respectively2 and 7#b7 by inserting after paragraph 7#d71 the following3 7#e7 maintain and disseminate information about the requirements of section #ajf7;b77#b77;,b77iii7 and best practices relating to the development of plans of safe care as described in such section for infants born and identified as being affected by illegal substance abuse or withdrawal symptoms1 or a ,fetal ,alcohol ,spectrum ,disorder2 4 #gjc4 ,state plans ,section #ajf7;b77#b77;,b77iii7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7b77#b77;,b77iii77 is amended by inserting before the semicolon at the end the following3 to ensure the safety and well-being of such infant following release from the care of healthcare providers1 including through-- 7,i7 addressing the health and substance use disorder treatment needs of the infant and affected family or caregiver2 and 7,,ii7 the development and implementation by the ,state of monitoring systems regarding the implementation of such plans to determine whether and in what manner local entities are providing1 in accordance with ,state requirements1 referrals to and delivery of appropriate services for the infant and affected family or caregiver 4 #gjd4 ,data reports 7a7 ,in general ,section #ajf7;d7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7d77 is amended by adding at the end of the following3 7#ag7 7,a7 ,the number of infants identified under subsection 7b77#b77;,b77ii74 7,b7 ,the number of infants for whom a plan of safe care was developed under subsection 7b77#b77;,b77iii74 7,c7 ,the number of infants for whom a referral was made for appropriate services1 including services for the affected family or caregiver1 under subsection 7b77#b77;,b77iii74 4 7b7 ,redesignation ,effective on ,may #bi1 #bjag1 section #ajf7;d7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7d77 is amended by redesignating paragraph 7#ag7 7as added by subsection 7a77 as paragraph 7#ah74 #gje4 ,monitoring and oversight 7a7 ,amendment ,title ,i of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja et seq47 is further amended by adding at the end the following3 #aad4 ,monitoring and oversight ,the ,secretary shall conduct monitoring to ensure that each ,state that receives a grant under section #ajf is in compliance with the requirements of section #ajf7;b71 which-- 7#a7 shall-- 7,a7 be in addition to the review of the ,state plan upon its submission under section #ajf7;b77#a77;,a72 and 7,b7 include monitoring of ,state policies and procedures required under clauses 7ii7 and 7iii7 of section #ajf7;b77#b77;,b72 and 7#b7 may include-- 7,a7 a comparison of activities carried out by the ,state to comply with the requirements of section #ajf7;b7 with the ,state plan most recently approved under section #dcb of the ,social ,security ,act2 7,b7 a review of information available on the ,website of the ,state relating to its compliance with the requirements of section #ajf7;b72 7,c7 site visits1 as may be necessary to carry out such monitoring2 and 7,d7 a review of information available in the ,state's ,annual ,progress and ,services ,report most recently submitted under section #aceg4af of title #de1 ,code of ,federal ,regulations 7or successor regulations74 4 7b7 ,table of contents ,the table of contents in section #a7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eaja note7 is amended by inserting after the item relating to section #aac1 the following3 ,sec4 #aad4 ,monitoring and oversight4 4 #gjf4 ,rule of construction ,nothing in this ,act1 or the amendments made by this ,act1 shall be construed to authorize the ,secretary of ,health and ,human ,services or any other officer of the ,federal ,government to add new requirements to section #ajf7;b7 of the ,child ,abuse ,prevention and ,treatment ,act 7#db ,u4,s4,c4 #eajf;a7b771 as amended by this ,act4 ,,viii ,,nas ,healthy ,babies ,act #hja4 ,short title ,this title may be cited as the ,nurturing ,and ,supporting ,healthy ,babies ,act or as the ,,nas ,healthy ,babies ,act4 #hjb4 ,,gao report on neonatal abstinence syndrome 7,,nas7 7a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor and ,pensions of the ,senate a report on neonatal abstinence syndrome 7in this section referred to as ,,nas7 in the ,united ,states4 7b7 ,information ,to be included in report ,such report shall include information on the following3 7#a7 ,the prevalence of ,,nas in the ,united ,states1 including the proportion of children born in the ,united ,states with ,,nas who are eligible for medical assistance under ,state ,medicaid programs under title ,,xix of the ,social ,security ,act at birth and the costs associated with ,,nas through such programs4 7#b7 ,the services for which coverage is available under ,state ,medicaid programs for treatment of infants with ,,nas4 7#c7 ,the settings 7including inpatient1 outpatient1 hospital-based1 and other settings7 for the treatment of infants with ,,nas and the reimbursement methodologies and costs associated with such treatment in such settings4 7#d7 ,the prevalence of utilization of various care settings under ,state ,medicaid programs for treatment of infants with ,,nas and any ,federal barriers to treating such infants under such programs1 particularly in non-hospital-based settings4 7#e7 ,what is known about best practices for treating infants with ,,nas4 7c7 ,recommendations ,such report also shall include such recommendations as the ,comptroller ,general determines appropriate for improvements that will ensure access to treatment for infants with ,,nas under ,state ,medicaid programs4 #hjc4 ,excluding abuse-deterrent formulations of prescription drugs from the ,medicaid additional rebate requirement for new formulations of prescription drugs 7a7 ,in general ,the last sentence of section #aibg7;c77#b77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7;c77#b77;,c77 is amended by inserting before the period at the end the following3 1 but does not include an abuse-deterrent formulation of the drug 7as determined by the ,secretary71 regardless of whether such abuse-deterrent formulation is an extended release formulation4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply to drugs that are paid for by a ,state in calendar quarters beginning on or after the date of the enactment of this ,act4 #hjd4 ,limiting disclosure of predictive modeling and other analytics technologies to identify and prevent waste1 fraud1 and abuse 7a7 ,in general ,title ,,xi of the ,social ,security ,act is amended by inserting after section #aabh;,j 7#db ,u4,s4,c4 #acbj;a-#gk7 the following new section3 #aabh,k4 ,disclosure of predictive modeling and other analytics technologies to identify and prevent waste1 fraud1 and abuse 7a7 ,reference to predictive modeling technologies requirements ,for provisions relating to the use of predictive modeling and other analytics technologies to identify and prevent waste1 fraud1 and abuse with respect to the ,medicare program under title ,,xviii1 the ,medicaid program under title ,,xix1 and the ,children's ,health ,insurance ,program under title ,,xxi1 see section #dbda of the ,small ,business ,jobs ,act of #bjaj 7#db ,u4,s4,c4 #acbj;a-#gm74 7b7 ,limiting disclosure of predictive modeling technologies ,in implementing such provisions under such section #dbda with respect to covered algorithms 7as defined in subsection 7c771 the following shall apply3 7#a7 ,nonapplication of ,,foia ,the covered algorithms used or developed for purposes of such section 7including by the ,secretary or a ,state 7or an entity operating under a contract with a ,state77 shall be exempt from disclosure under section #eeb7;b77#c7 of title #e1 ,united ,states ,code4 7#b7 ,limitation with respect to use and disclosure of information by ,state agencies 7,a7 ,in general ,a ,state agency may not use or disclose covered algorithms used or developed for purposes of such section except for purposes of administering the ,state plan 7or a waiver of the plan7 under the ,medicaid program under title ,,xix or the ,state child health plan 7or a waiver of the plan7 under the ,children's ,health ,insurance ,program under title ,,xxi1 including by enabling an entity operating under a contract with a ,state to assist the ,state to identify or prevent waste1 fraud1 and abuse with respect to such programs4 7,b7 ,information security ,a ,state agency shall have in effect data security and control policies that the ,secretary finds adequate to ensure the security of covered algorithms used or developed for purposes of such section #dbda and to ensure that access to such information is restricted to authorized persons for purposes of authorized uses and disclosures described in subparagraph 7,a74 7,c7 ,procedural requirements ,state agencies to which information is disclosed pursuant to such section #dbda shall adhere to uniform procedures established by the ,secretary4 7c7 ,covered algorithm defined ,in this section1 the term covered algorithm-- 7#a7 means a predictive modeling or other analytics technology1 as used for purposes of section #dbda7;a7 of the ,small ,business ,jobs ,act of #bjaj 7#db ,u4,s4,c4 #acbj;a-#gm7a77 to identify and prevent waste1 fraud1 and abuse with respect to the ,medicare program under title ,,xviii1 the ,medicaid program under title ,,xix1 and the ,children's ,health ,insurance ,program under title ,,xxi2 and 7#b7 includes the mathematical expressions utilized in the application of such technology and the means by which such technology is developed4 4 7b7 ,conforming amendments 7#a7 ,medicaid ,state plan requirement ,section #aijb7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77 is amended-- 7,a7 in paragraph 7#hj71 by striking and at the end2 7,b7 in paragraph 7#ha71 by striking the period at the end and inserting 2 and2 and 7,c7 by inserting after paragraph 7#ha7 the following new paragraph3 7#hb7 provide that the ,state agency responsible for administering the ,state plan under this title provides assurances to the ,secretary that the ,state agency is in compliance with subparagraphs 7,a71 7,b71 and 7,c7 of section #aabh,k7b77#b74 4 7#b7 ,state child health plan requirement ,section #bajb7;a77#g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7a77#g77 is amended-- 7,a7 in subparagraph 7,a71 by striking 1 and at the end and inserting a semicolon2 7,b7 in subparagraph 7,b71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,c7 to ensure that the ,state agency involved is in compliance with subparagraphs 7,a71 7,b71 and 7,c7 of section #aabh,k7b77#b74 4 #hje4 ,medicaid ,improvement ,fund ,section #aida7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#a7;b77#a77 is amended to read as follows3 7#a7 ,in general ,there shall be available to the ,fund1 for expenditures from the ,fund for fiscal year #bjba and thereafter1 #e1jjj1jjj4 4 ,,ix ,co-,prescribing to ,reduce ,overdoses ,act #ija4 ,short title ,this title may be cited as the ,co-,prescribing to ,reduce ,overdoses ,act of #bjaf4 #ijb4 ,opioid overdose reversal drugs prescribing grant program 7a7 ,establishment 7#a7 ,in general ,not later than #f months after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services may establish1 in accordance with this section1 a #e-year opioid overdose reversal drugs prescribing grant program 7in this ,act referred to as the grant program74 7#b7 ,maximum grant amount ,a grant made under this section may not be for more than #bjj1jjj per grant year4 7#c7 ,eligible entity ,for purposes of this section1 the term eligible entity means a federally qualified health center 7as defined in section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa771 an opioid treatment program under part #h of title #db1 ,code of ,federal ,regulations1 any practitioner dispensing narcotic drugs pursuant to section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g771 or any other entity that the ,secretary deems appropriate4 7#d7 ,prescribing ,for purposes of this section and section #c1 the term prescribing means1 with respect to an opioid overdose reversal drug1 such as naloxone1 the practice of prescribing such drug-- 7,a7 in conjunction with an opioid prescription for patients at an elevated risk of overdose2 7,b7 in conjunction with an opioid agonist approved under section #eje of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7 for the treatment of opioid abuse disorder2 7,c7 to the caregiver or a close relative of patients at an elevated risk of overdose from opioids2 or 7,d7 in other circumstances1 as identified by the ,secretary1 in which a provider identifies a patient is at an elevated risk for an intentional or unintentional drug overdose from heroin or prescription opioid therapies4 7b7 ,application ,to be eligible to receive a grant under this section1 an eligible entity shall submit to the ,secretary of ,health and ,human ,services1 in such form and manner as specified by the ,secretary1 an application that describes-- 7#a7 the extent to which the area to which the entity will furnish services through use of the grant is experiencing significant morbidity and mortality caused by opioid abuse2 7#b7 the criteria that will be used to identify eligible patients to participate in such program2 and 7#c7 how such program will work to try to identify ,state1 local1 or private funding to continue the program after expiration of the grant4 7c7 ,use of funds ,an eligible entity receiving a grant under this section may use the grant for any of the following activities1 but may use not more than #bj percent of the grant funds for activities described in paragraphs 7#d7 and 7#e73 7#a7 ,to establish a program for prescribing opioid overdose reversal drugs1 such as naloxone4 7#b7 ,to train and provide resources for health care providers and pharmacists on the prescribing of opioid overdose reversal drugs1 such as naloxone4 7#c7 ,to establish mechanisms and processes for tracking patients participating in the program described in paragraph 7#a7 and the health outcomes of such patients4 7#d7 ,to purchase opioid overdose reversal drugs1 such as naloxone1 for distribution under the program described in paragraph 7#a74 7#e7 ,to offset the co-pays and other cost sharing associated with opioid overdose reversal drugs1 such as naloxone1 to ensure that cost is not a limiting factor for eligible patients4 7#f7 ,to conduct community outreach1 in conjunction with community-based organizations1 designed to raise awareness of prescribing practices1 and the availability of opioid overdose reversal drugs1 such as naloxone4 7#g7 ,to establish protocols to connect patients who have experienced a drug overdose with appropriate treatment1 including medication assisted treatment and appropriate counseling and behavioral therapies4 7d7 ,evaluations by recipients ,as a condition of receipt of a grant under this section1 an eligible entity shall1 for each year for which the grant is received1 submit to the ,secretary of ,health and ,human ,services information on appropriate outcome measures specified by the ,secretary to assess the outcomes of the program funded by the grant1 including-- 7#a7 the number of prescribers trained2 7#b7 the number of prescribers who have co-prescribed an opioid overdose reversal drug1 such as naloxone1 to at least one patient2 7#c7 the total number of prescriptions written for opioid overdose reversal drugs1 such as naloxone2 7#d7 the percentage of patients at elevated risk who received a prescription for an opioid overdose reversal drug1 such as naloxone2 7#e7 the number of patients reporting use of an opioid overdose reversal drug1 such as naloxone2 and 7#f7 any other outcome measures that the ,secretary deems appropriate4 7e7 ,reports by ,secretary ,for each year of the grant program under this section1 the ,secretary of ,health and ,human ,services shall submit to the appropriate committees of the ,house of ,representatives and of the ,senate a report aggregating the information received from the grant recipients for such year under subsection 7d7 and evaluating the outcomes achieved by the programs funded by grants made under this section4 #ijc4 ,providing information to prescribers in certain ,federal health care and medical facilities on best practices for prescribing opioid overdose reversal drugs 7a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary7 may1 as appropriate1 provide information to prescribers within federally qualified health centers 7as defined in paragraph 7#d7 of section #ahfa7;aa7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa7771 and the health care facilities of the ,indian ,health ,service1 on best practices for prescribing opioid overdose reversal drugs1 such as naloxone1 for patients receiving chronic opioid therapy1 patients being treated for opioid use disorders1 and other patients that a provider identifies as having an elevated risk of overdose from heroin or prescription opioid therapies4 7b7 ,not establishing a medical standard of care ,the information on best practices provided under this section shall not be construed as constituting or establishing a medical standard of care for prescribing opioid overdose reversal drugs1 such as naloxone1 for patients described in subsection 7a74 7c7 ,elevated risk of overdose defined ,in this section1 the term elevated risk of overdose has the meaning given such term by the ,secretary1 which-- 7#a7 may be based on the criteria provided in the ,opioid ,overdose ,toolkit published by the ,substance ,abuse and ,mental ,health ,services ,administration 7,,samhsa72 and 7#b7 may include patients on a first course opioid treatment1 patients using extended-release and long-acting opioid analgesics1 and patients with a respiratory disease or other co-morbidities4 #ijd4 ,authorization of appropriations ,there is authorized to be appropriated to carry out this title #e1jjj1jjj for the period of fiscal years #bjag through #bjba4 #ije4 ,cut-,go ,compliance ,subsection 7f7 of section #cai;,d of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#d7 is amended by inserting before the period at the end the following3 7except such dollar amount shall be reduced by #e1jjj1jjj for fiscal year #bjah74 ,x ,improving ,treatment for ,pregnant and ,postpartum ,women ,act #ajja4 ,short title ,this title may be cited as the ,improving ,treatment for ,pregnant and ,postpartum ,women ,act of #bjaf4 #ajjb4 ,reauthorization of residential treatment programs for pregnant and postpartum women ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 in subsection 7p71 in the first sentence1 by inserting 7other than subsection 7r77 after section2 and 7#b7 in subsection 7r71 by striking such sums and all that follows through #bjjc and inserting #af1ijj1jjj for each of fiscal years #bjag through #bjba4 #ajjc4 ,pilot program grants for ,state substance abuse agencies 7a7 ,in general ,section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a7 is amended-- 7#a7 by redesignating subsection 7r71 as amended by section #b1 as subsection 7s72 and 7#b7 by inserting after subsection 7q7 the following new subsection3 7r7 ,pilot program for ,state substance abuse agencies 7#a7 ,in general ,from amounts made available under subsection 7s71 the ,director of the ,center for ,substance ,abuse ,treatment shall carry out a pilot program under which competitive grants are made by the ,director to ,state substance abuse agencies to-- 7,a7 enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,b7 help ,state substance abuse agencies address identified gaps in services furnished to such women along the continuum of care1 including services provided to women in nonresidential based settings2 and 7,c7 promote a coordinated1 effective1 and efficient ,state system managed by ,state substance abuse agencies by encouraging new approaches and models of service delivery4 7#b7 ,requirements ,in carrying out the pilot program under this subsection1 the ,director shall-- 7,a7 require ,state substance abuse agencies to submit to the ,director applications1 in such form and manner and containing such information as specified by the ,director1 to be eligible to receive a grant under the program2 7,b7 identify1 based on such submitted applications1 ,state substance abuse agencies that are eligible for such grants2 7,c7 require services proposed to be furnished through such a grant to support family-based treatment and other services for pregnant and postpartum women with a primary diagnosis of a substance use disorder1 including opioid use disorders2 7,d7 not require that services furnished through such a grant be provided solely to women that reside in facilities2 7,e7 not require that grant recipients under the program make available through use of the grant all services described in subsection 7d72 and 7,f7 consider not applying requirements described in paragraphs 7#a7 and 7#b7 of subsection 7f7 to applicants1 depending on the circumstances of the applicant4 7#c7 ,required services 7,a7 ,in general ,the ,director shall specify a minimum set of services required to be made available to eligible women through a grant awarded under the pilot program under this subsection4 ,such minimum set-- 7i7 shall include requirements described in subsection 7c7 and be based on the recommendations submitted under subparagraph 7,b72 and 7ii7 may be selected from among the services described in subsection 7d7 and include other services as appropriate4 7,b7 ,stakeholder input ,the ,director shall convene and solicit recommendations from stakeholders1 including ,state substance abuse agencies1 health care providers1 persons in recovery from substance abuse1 and other appropriate individuals1 for the minimum set of services described in subparagraph 7,a74 7#d7 ,duration ,the pilot program under this subsection shall not exceed #e years4 7#e7 ,evaluation and ,report to ,congress ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality shall fund an evaluation of the pilot program at the conclusion of the first grant cycle funded by the pilot program4 ,the ,director of the ,center for ,behavioral ,health ,statistics and ,quality1 in coordination with the ,director of the ,center for ,substance ,abuse ,treatment shall submit to the relevant committees of jurisdiction of the ,house of ,representatives and the ,senate a report on such evaluation4 ,the report shall include at a minimum outcomes information from the pilot program1 including any resulting reductions in the use of alcohol and other drugs2 engagement in treatment services2 retention in the appropriate level and duration of services2 increased access to the use of medications approved by the ,food and ,drug ,administration for the treatment of substance use disorders in combination with counseling2 and other appropriate measures4 7#f7 ,state substance abuse agencies defined ,for purposes of this subsection1 the term ,state substance abuse agency means1 with respect to a ,state1 the agency in such ,state that manages the ,substance ,abuse ,prevention and ,treatment ,block ,grant under part ,b of title ,,xix4 4 7b7 ,funding ,subsection 7s7 of section #ejh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#a71 as amended by section #ajjb and redesignated by subsection 7a71 is further amended by adding at the end the following new sentence3 ,of the amounts made available for a year pursuant to the previous sentence to carry out this section1 not more than #be percent of such amounts shall be made available for such year to carry out subsection 7r71 other than paragraph 7#e7 of such subsection4 ,notwithstanding the preceding sentence1 no funds shall be made available to carry out subsection 7r7 for a fiscal year unless the amount made available to carry out this section for such fiscal year is more than the amount made available to carry out this section for fiscal year #bjaf44 #ajjd4 ,cut-,go ,compliance ,subsection 7f7 of section #cai;,d of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#d7 is amended by striking through #bjah and inserting through #bjaf1 #acc1cjj1jjj for fiscal year #bjag1 and #ach1cjj1jjj for fiscal year #bjah4 ,,xi ,veteran ,emergency ,medical ,technician ,support ,act #aaja4 ,short title ,this title may be cited as the ,veteran ,emergency ,medical ,technician ,support ,act of #bjaf4 #aajb4 ,assisting veterans with military emergency medical training to meet requirements for becoming civilian emergency medical technicians ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq47 is amended by inserting after section #cad the following3 #cae4 ,assisting veterans with military emergency medical training to meet requirements for becoming civilian emergency medical technicians 7a7 ,program ,the ,secretary shall establish a program consisting of awarding demonstration grants to ,states to streamline ,state requirements and procedures in order to assist veterans who completed military emergency medical technician training while serving in the ,armed ,forces of the ,united ,states to meet certification1 licensure1 and other requirements applicable to becoming an emergency medical technician in the ,state4 7b7 ,use of funds ,amounts received as a demonstration grant under this section shall be used to prepare and implement a plan to streamline ,state requirements and procedures as described in subsection 7a71 including by-- 7#a7 determining the extent to which the requirements for the education1 training1 and skill level of emergency medical technicians in the ,state are equivalent to requirements for the education1 training1 and skill level of military emergency medical technicians2 and 7#b7 identifying methods1 such as waivers1 for military emergency medical technicians to forgo or meet any such equivalent ,state requirements4 7c7 ,eligibility ,to be eligible for a grant under this section1 a ,state shall demonstrate that the ,state has a shortage of emergency medical technicians4 7d7 ,report ,the ,secretary shall submit to the ,congress an annual report on the program under this section4 7e7 ,funding ,no additional funds are authorized to be appropriated for the purpose of carrying out this section4 ,this section shall be carried out using amounts otherwise available for such purpose4 4 ,,xii ,john ,thomas ,decker ,act #abja4 ,short title ,this title may be cited as the ,john ,thomas ,decker ,act of #bjaf4 #abjb4 ,information materials and resources to prevent addiction related to youth sports injuries 7a7 ,technical clarification ,effective as if included in the enactment of the ,children's ,health ,act of #bjjj 7,public ,law #ajf-caj71 section #cdje7;a7 of such ,act 7#aad ,stat4 #abba7 is amended by striking ,part ,e of title ,,iii and inserting ,part ,e of title ,,iii of the ,public ,health ,service ,act4 7b7 ,amendment ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after part ,d of such title 7#db ,u4,s4,c4 #bed;b et seq47 the following new part ,e3 ,e ,opioid ,use ,disorder #cda4 ,information materials and resources to prevent addiction related to youth sports injuries 7a7 ,report ,the ,secretary shall-- 7#a7 not later than #bd months after the date of the enactment of this section1 make publicly available a report determining the extent to which informational materials and resources described in subsection 7b7 are available to teenagers and adolescents who play youth sports1 families of such teenagers and adolescents1 nurses1 youth sports groups1 and relevant health care provider groups2 and 7#b7 for purposes of educating and preventing addiction in teenagers and adolescents who are injured playing youth sports and are subsequently prescribed an opioid1 not later than #ab months after such report is made publicly available and taking into consideration the findings of such report1 develop and1 in coordination with youth sports groups1 disseminate informational materials and resources described in subsection 7b7 for teenagers and adolescents who play youth sports1 families of such teenagers and adolescents1 nurses1 youth sports groups1 and relevant health care provider groups4 7b7 ,materials and resources described ,for purposes of this section1 the informational materials and resources described in this subsection are informational materials and resources with respect to youth sports injuries for which opioids are potentially prescribed and subsequently potentially lead to addiction1 including materials and resources focused on the dangers of opioid use and misuse1 treatment options for such injuries that do not involve the use of opioids1 and how to seek treatment for addiction4 7c7 ,no additional funds ,no additional funds are authorized to be appropriated for the purpose of carrying out this section4 ,this section shall be carried out using amounts otherwise available for such purpose4 4 ,,xiii ,lali's ,law #acja4 ,short title ,this title may be cited as ,lali's ,law4 #acjb4 ,opioid overdose reversal medication access and education grant programs 7a7 ,technical clarification ,effective as if included in the enactment of the ,children's ,health ,act of #bjjj 7,public ,law #ajf-caj71 section #cdje7;a7 of such ,act 7#aad ,stat4 #abba7 is amended by striking ,part ,e of title ,,iii and inserting ,part ,e of title ,,iii of the ,public ,health ,service ,act4 7b7 ,amendment ,title ,,iii of the ,public ,health ,service ,act is amended by inserting after part ,d of such title 7#db ,u4,s4,c4 #bed;b et seq47 the following new part ,e3 ,e ,opioid ,use ,disorder #cda4 ,opioid overdose reversal medication access and education grant programs 7a7 ,grants to ,states ,the ,secretary may make grants to ,states for-- 7#a7 developing standing orders for pharmacies regarding opioid overdose reversal medication2 7#b7 encouraging pharmacies to dispense opioid overdose reversal medication pursuant to a standing order2 7#c7 implementing best practices for persons authorized to prescribe medication regarding-- 7,a7 prescribing opioids for the treatment of chronic pain2 7,b7 co-prescribing opioid overdose reversal medication with opioids2 and 7,c7 discussing the purpose and administration of opioid overdose reversal medication with patients2 7#d7 developing or adapting training materials and methods for persons authorized to prescribe or dispense medication to use in educating the public regarding-- 7,a7 when and how to administer opioid overdose reversal medication2 and 7,b7 steps to be taken after administering opioid overdose reversal medication2 and 7#e7 educating the public regarding-- 7,a7 the public health benefits of opioid overdose reversal medication2 and 7,b7 the availability of opioid overdose reversal medication without a person-specific prescription4 7b7 ,certain requirement ,a grant may be made under this section only if the ,state involved has authorized standing orders regarding opioid overdose reversal medication4 7c7 ,preference in making grants ,in making grants under this section1 the ,secretary shall give preference to ,states that-- 7#a7 have not issued standing orders regarding opioid overdose reversal medication2 7#b7 authorize standing orders that permit community-based organizations1 substance abuse programs1 or other nonprofit entities to acquire1 dispense1 or administer opioid overdose reversal medication2 7#c7 authorize standing orders that permit police1 fire1 or emergency medical services agencies to acquire and administer opioid overdose reversal medication2 7#d7 have a higher per capita rate of opioid overdoses than other applicant ,states2 or 7#e7 meet any other criteria deemed appropriate by the ,secretary4 7d7 ,grant terms 7#a7 ,number ,a ,state may not receive more than one grant under this section4 7#b7 ,period ,a grant under this section shall be for a period of #c years4 7#c7 ,amount ,a grant under this section may not exceed #ejj1jjj4 7#d7 ,limitation ,a ,state may use not more than #bj percent of a grant under this section for educating the public pursuant to subsection 7a77#e74 7e7 ,applications ,to be eligible to receive a grant under this section1 a ,state shall submit an application to the ,secretary in such form and manner and containing such information as the ,secretary may require1 including detailed proposed expenditures of grant funds4 7f7 ,reporting ,not later than #c months after the ,secretary disburses the first grant payment to any ,state under this section and every #f months thereafter for #c years1 such ,state shall submit a report to the ,secretary that includes the following3 7#a7 ,the name and ,,zip ,code of each pharmacy in the ,state that dispenses opioid overdose reversal medication under a standing order4 7#b7 ,the total number of opioid overdose reversal medication doses dispensed by each such pharmacy1 specifying how many were dispensed with or without a person-specific prescription4 7#c7 ,the number of pharmacists in the ,state who have participated in training pursuant to subsection 7a77#d74 7g7 ,definitions ,in this section3 7#a7 ,opioid overdose reversal medication ,the term opioid overdose reversal medication means any drug1 including naloxone1 that-- 7,a7 blocks opioids from attaching to1 but does not itself activate1 opioid receptors2 or 7,b7 inhibits the effects of opioids on opioid receptors4 7#b7 ,standing order ,the term standing order means a document prepared by a person authorized to prescribe medication that permits another person to acquire1 dispense1 or administer medication without a person-specific prescription4 7h7 ,authorization of appropriations 7#a7 ,in general ,to carry out this section1 there is authorized to be appropriated #e1jjj1jjj for the period of fiscal years #bjag through #bjai4 7#b7 ,administrative costs ,not more than #c percent of the amounts made available to carry out this section may be used by the ,secretary for administrative expenses of carrying out this section4 4 #acjc4 ,cut-,go ,compliance ,subsection 7f7 of section #cai;,d of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#d7 is amended by inserting before the period at the end the following3 7except such dollar amount shall be reduced by #e1jjj1jjj for fiscal year #bjag74 ,,xiv ,reducing ,unused ,medications ,act #adja4 ,short title ,this title may be cited as the ,reducing ,unused ,medications ,act of #bjaf4 #adjb4 ,partial fills of schedule ,,ii controlled substances 7a7 ,in general ,section #cji of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbi7 is amended by adding at the end the following3 7f7 ,partial fills of schedule ,,ii controlled substances 7#a7 ,partial fills 7,a7 ,in general ,a prescription for a controlled substance in schedule ,,ii may be partially filled if-- 7i7 it is not prohibited by ,state law2 7ii7 the prescription is written and filled in accordance with the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq471 regulations prescribed by the ,attorney ,general1 and ,state law2 7iii7 the partial fill is requested by the patient or the practitioner that wrote the prescription2 and 7iv7 the total quantity dispensed in all partial fillings does not exceed the total quantity prescribed4 7,b7 ,other circumstances ,a prescription for a controlled substance in schedule ,,ii may be partially filled in accordance with section #acjf4ac of title #ba1 ,code of ,federal ,regulations 7as in effect on the date of enactment of the ,reducing ,unused ,medications ,act74 7#b7 ,remaining portions 7,a7 ,in general ,except as provided in subparagraph 7,b71 remaining portions of a partially filled prescription for a controlled substance in schedule ,,ii-- 7i7 may be filled2 and 7ii7 shall be filled not later than #cj days after the date on which the prescription is written4 7,b7 ,emergency situations ,in emergency situations1 as described in subsection 7a71 the remaining portions of a partially filled prescription for a controlled substance in schedule ,,ii-- 7i7 may be filled2 and 7ii7 shall be filled not later than #gb hours after the prescription is issued4 4 7b7 ,rule of construction ,nothing in this section shall be construed to affect the authority of the ,attorney ,general to allow a prescription for a controlled substance in schedule ,,iii1 ,,iv1 or ,v of section #bjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7;c77 to be partially filled4 ,,xv ,opioid ,review ,modernization ,act #aeja4 ,short title ,this title may be cited as the ,opioid ,review ,modernization ,act of #bjaf4 #aejb4 ,,fda opioid action plan ,chapter ,v of the ,federal ,food1 ,drug1 and ,cosmetic ,act is amended by inserting after section #efi of such ,act 7#ba ,u4,s4,c4 #cej;bbb-#h7 the following3 #efi-a4 ,opioid action plan 7a7 ,new drug application 7#a7 ,in general ,subject to paragraph 7#b71 prior to the approval pursuant to an application under section #eje7;b7 of a new drug that is an opioid and does not have abuse-deterrent properties1 the ,secretary shall refer the application to an advisory committee of the ,food and ,drug ,administration to seek recommendations from such advisory committee4 7#b7 ,public health exemption ,a referral to an advisory committee under paragraph 7#a7 is not required with respect to a new drug if the ,secretary-- 7,a7 finds that such a referral is not in the interest of protecting and promoting public health2 7,b7 finds that such a referral is not necessary based on a review of the relevant scientific information2 and 7,c7 submits a notice containing the rationale for such findings to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives4 7b7 ,pediatric opioid labeling ,the ,secretary shall convene the ,pediatric ,advisory ,committee of the ,food and ,drug ,administration to seek recommendations from such ,committee regarding a framework for the inclusion of information in the labeling of drugs that are opioids relating to the use of such drugs in pediatric populations before the ,secretary approves any labeling or change to labeling for any drug that is an opioid intended for use in a pediatric population4 7c7 ,sunset ,the requirements of subsections 7a7 and 7b7 shall cease to be effective on ,october #a1 #bjbb4 4 #aejc4 ,prescriber education ,not later than #a year after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services1 acting through the ,commissioner of ,food and ,drugs1 as part of the ,food and ,drug ,administration's evaluation of the ,extended-,release_/,long-,acting ,opioid ,analgesics ,risk ,evaluation and ,mitigation ,strategy1 and in consultation with relevant stakeholders1 shall develop recommendations regarding education programs for prescribers of opioids pursuant to section #eje-a of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee-a71 including recommendations on-- 7#a7 which prescribers should participate in such programs2 and 7#b7 how often participation in such programs is necessary4 #aejd4 ,guidance on evaluating the abuse deterrence of generic solid oral opioid drug products ,not later than #b years after the end of the period for public comment on the draft guidance entitled ,general ,principals for ,evaluating the ,abuse ,deterrence of ,generic ,solid ,oral ,opioid ,drug ,products issued by the ,center for ,drug ,evaluation and ,research of the ,food and ,drug ,administration in ,march #bjaf1 the ,commissioner of ,food and ,drugs shall publish in the ,federal ,register a final version of such guidance4 ,,xvi ,examining ,opioid ,treatment ,infrastructure ,act #afja4 ,short title ,this title may be cited as the ,examining ,opioid ,treatment ,infrastructure ,act of #bjaf4 #afjb4 ,study on treatment infrastructure ,not later than #bd months after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall initiate an evaluation1 and submit to ,congress a report1 of the inpatient and outpatient treatment capacity1 availability1 and needs of the ,united ,states1 which shall include1 to the extent data are available-- 7#a7 the capacity of acute residential or inpatient detoxification programs2 7#b7 the capacity of inpatient clinical stabilization programs1 transitional residential support services1 and residential rehabilitation programs2 7#c7 the capacity of demographic specific residential or inpatient treatment programs1 such as those designed for pregnant women or adolescents2 7#d7 geographical differences of the availability of residential and outpatient treatment and recovery options for substance use disorders across the continuum of care2 7#e7 the availability of residential and outpatient treatment programs that offer treatment options based on reliable scientific evidence of efficacy for the treatment of substance use disorders1 including the use of ,food and ,drug ,administration-approved medicines and evidence-based nonpharmacological therapies2 7#f7 the number of patients in residential and specialty outpatient treatment services for substance use disorders2 7#g7 an assessment of the need for residential and outpatient treatment for substance use disorders across the continuum of care2 7#h7 the availability of residential and outpatient treatment programs to ,american ,indians and ,alaska ,natives through an ,indian health program 7as defined by section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc772 and 7#i7 the barriers 7including technological barriers7 at the ,federal1 ,state1 and local levels to real-time reporting of de-identified information on drug overdoses and ways to overcome such barriers4 ,,xvii ,opioid ,use ,disorder ,treatment ,expansion and ,modernization ,act #agja4 ,short title ,this title may be cited as the ,opioid ,use ,disorder ,treatment ,expansion and ,modernization ,act4 #agjb4 ,finding ,the ,congress finds that opioid use disorder has become a public health epidemic that must be addressed by increasing awareness and access to all treatment options for opioid use disorder1 overdose reversal1 and relapse prevention4 #agjc4 ,opioid use disorder treatment modernization 7a7 ,in general ,section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 is amended-- 7#a7 in subparagraph 7,b71 by striking clauses 7i71 7ii71 and 7iii7 and inserting the following3 7i7 ,the practitioner is a qualifying practitioner 7as defined in subparagraph 7,g774 7ii7 ,with respect to patients to whom the practitioner will provide such drugs or combinations of drugs1 the practitioner has the capacity to provide directly1 by referral1 or in such other manner as determined by the ,secretary-- 7,i7 all schedule ,,iii1 ,,iv1 and ,v drugs1 as well as unscheduled medications approved by the ,food and ,drug ,administration1 for the treatment of opioid use disorder1 including such drugs and medications for maintenance1 detoxification1 overdose reversal1 and relapse prevention1 as available2 and 7,,ii7 appropriate counseling and other appropriate ancillary services4 7iii7 7,i7 ,the total number of such patients of the practitioner at any one time will not exceed the applicable number4 ,except as provided in subclause 7,,ii71 the applicable number is #cj4 7,,ii7 ,the applicable number is #ajj if1 not sooner than #a year after the date on which the practitioner submitted the initial notification1 the practitioner submits a second notification to the ,secretary of the need and intent of the practitioner to treat up to #ajj patients4 7,,iii7 ,the ,secretary may by regulation change such total number4 7,,iv7 ,the ,secretary may exclude from the applicable number patients to whom such drugs or combinations of drugs are directly administered by the qualifying practitioner in the office setting4 7iv7 ,if the ,secretary by regulation increases the total number of patients which a qualifying practitioner is permitted to treat pursuant to clause 7iii77,,ii71 the ,secretary shall require such a practitioner to obtain a written agreement from each patient1 including the patient's signature1 that the patient-- 7,i7 will receive an initial assessment and treatment plan and periodic assessments and treatment plans thereafter2 7,,ii7 will be subject to medication adherence and substance use monitoring2 7,,iii7 understands available treatment options1 including all drugs approved by the ,food and ,drug ,administration for the treatment of opioid use disorder1 including their potential risks and benefits2 and 7,,iv7 understands that receiving regular counseling services is critical to recovery4 7v7 ,the practitioner will comply with the reporting requirements of subparagraph 7,d77i77,,iv74 2 7#b7 in subparagraph 7,d7-- 7,a7 in clause 7i71 by adding at the end the following3 7,,iv7 ,the practitioner reports to the ,secretary1 at such times and in such manner as specified by the ,secretary1 such information and assurances as the ,secretary determines necessary to assess whether the practitioner continues to meet the requirements for a waiver under this paragraph4 2 7,b7 in clause 7ii71 by striking ,upon receiving a notification under subparagraph 7,b7 and inserting ,upon receiving a determination from the ,secretary under clause 7iii7 finding that a practitioner meets all requirements for a waiver under subparagraph 7,b72 and 7,c7 in clause 7iii7-- 7i7 by inserting and shall forward such determination to the ,attorney ,general before the period at the end of the first sentence2 and 7ii7 by striking physician and inserting practitioner2 7#c7 in subparagraph 7,g7-- 7,a7 by amending clause 7ii77,,iv7 to read as follows3 7,,iv7 ,the physician has1 with respect to the treatment and management of opiate-dependent patients1 completed not less than #h hours of training 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 that is provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,psychiatric ,association1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 ,such training shall address-- 7aa7 opioid maintenance and detoxification2 7bb7 appropriate clinical use of all drugs approved by the ,food and ,drug ,administration for the treatment of opioid use disorder2 7cc7 initial and periodic patient assessments 7including substance use monitoring72 7dd7 individualized treatment planning2 overdose reversal2 relapse prevention2 7ee7 counseling and recovery support services2 7ff7 staffing roles and considerations2 7gg7 diversion control2 and 7hh7 other best practices1 as identified by the ,secretary4 2 and 7,b7 by adding at the end the following3 7iii7 ,the term qualifying practitioner means-- 7,i7 a qualifying physician1 as defined in clause 7ii72 or 7,,ii7 during the period beginning on the date of the enactment of the ,opioid ,use ,disorder ,treatment ,expansion and ,modernization ,act and ending on the date that is #c years after such date of enactment1 a qualifying other practitioner1 as defined in clause 7iv74 7iv7 ,the term qualifying other practitioner means a nurse practitioner or physician assistant who satisfies each of the following3 7,i7 ,the nurse practitioner or physician assistant is licensed under ,state law to prescribe schedule ,,iii1 ,,iv1 or ,v medications for the treatment of pain4 7,,ii7 ,the nurse practitioner or physician assistant satisfies one or more of the following3 7aa7 ,has completed not fewer than #bd hours of initial training addressing each of the topics listed in clause 7ii77,,iv7 7through classroom situations1 seminars at professional society meetings1 electronic communications1 or otherwise7 provided by the ,american ,society of ,addiction ,medicine1 the ,american ,academy of ,addiction ,psychiatry1 the ,american ,medical ,association1 the ,american ,osteopathic ,association1 the ,american ,nurses ,credentialing ,center1 the ,american ,psychiatric ,association1 the ,american ,association of ,nurse ,practitioners1 the ,american ,academy of ,physician ,assistants1 or any other organization that the ,secretary determines is appropriate for purposes of this subclause4 7bb7 ,has such other training or experience as the ,secretary determines will demonstrate the ability of the nurse practitioner or physician assistant to treat and manage opiate-dependent patients4 7,,iii7 ,the nurse practitioner or physician assistant is supervised by or works in collaboration with a qualifying physician1 if the nurse practitioner or physician assistant is required by ,state law to prescribe medications for the treatment of opioid use disorder in collaboration with or under the supervision of a physician4 ,the ,secretary may review and update the requirements for being a qualifying other practitioner under this clause4 2 and 7#d7 in subparagraph 7,h7-- 7,a7 in clause 7i71 by inserting after subclause 7,,ii7 the following3 7,,iii7 ,such other elements of the requirements under this paragraph as the ,secretary determines necessary for purposes of implementing such requirements4 2 and 7,b7 by amending clause 7ii7 to read as follows3 7ii7 ,not later than #a year after the date of enactment of the ,opioid ,use ,disorder ,treatment ,expansion and ,modernization ,act1 the ,secretary shall update the treatment improvement protocol containing best practice guidelines for the treatment of opioid-dependent patients in office-based settings4 ,the ,secretary shall update such protocol in consultation with experts in opioid use disorder research and treatment4 4 7b7 ,recommendation of revocation or suspension of registration in case of substantial noncompliance ,the ,secretary of ,health and ,human ,services may recommend to the ,attorney ,general that the registration of a practitioner be revoked or suspended if the ,secretary determines1 according to such criteria as the ,secretary establishes by regulation1 that a practitioner who is registered under section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 is not in substantial compliance with the requirements of such section1 as amended by this ,act4 7c7 ,opioid defined ,section #ajb7ah7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7ah77 is amended by inserting or opioid after ,the term opiate4 7d7 ,reports to ,congress 7#a7 ,in general ,not later than #b years after the date of enactment of this ,act and not less than over every #e years thereafter1 the ,secretary of ,health and ,human ,services1 in consultation with the ,drug ,enforcement ,administration and experts in opioid use disorder research and treatment1 shall-- 7,a7 perform a thorough review of the provision of opioid use disorder treatment services in the ,united ,states1 including services provided in opioid treatment programs and other specialty and nonspecialty settings2 and 7,b7 submit a report to the ,congress on the findings and conclusions of such review4 7#b7 ,contents ,each report under paragraph 7#a7 shall include an assessment of-- 7,a7 compliance with the requirements of section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b771 as amended by this ,act2 7,b7 the measures taken by the ,secretary of ,health and ,human ,services to ensure such compliance2 7,c7 whether there is further need to increase or decrease the number of patients a waivered practitioner is permitted to treat1 as provided for by the amendment made by subsection 7a77#a72 7,d7 the extent to which1 and proportions with which1 the full range of ,food and ,drug ,administration-approved treatments for opioid use disorder are used in routine health care settings and specialty substance use disorder treatment settings2 7,e7 access to1 and use of1 counseling and recovery support services1 including the percentage of patients receiving such services2 7,f7 changes in ,state or local policies and legislation relating to opioid use disorder treatment2 7,g7 the use of prescription drug monitoring programs by practitioners who are permitted to dispense narcotic drugs to individuals pursuant to a waiver under section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b772 7,h7 the findings resulting from inspections by the ,drug ,enforcement ,administration of practitioners described in subparagraph 7,g72 and 7,i7 the effectiveness of cross-agency collaboration between ,department of ,health and ,human ,services and the ,drug ,enforcement ,administration for expanding effective opioid use disorder treatment4 #agjd4 ,sense of ,congress ,it is the ,sense of ,congress that1 with respect to the total number of patients that a qualifying physician 7as defined in subparagraph 7,g77iii7 of section #cjc7;g77#b7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77#b77 can treat at any one time pursuant to such section1 the ,secretary of ,health and ,human ,services should consider raising such total number to #bej patients following a third notification to the ,secretary of the need and intent of the physician to treat up to #bej patients that is submitted to the ,secretary not sooner than #a year after the date on which the physician submitted to the ,secretary a second notification to treat up to #ajj patients4 #agje4 ,partial fills of schedule ,,ii controlled substances 7a7 ,in general ,section #cji of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbi7 is amended by adding at the end the following3 7f7 ,partial fills of schedule ,,ii controlled substances 7#a7 ,partial fills 7,a7 ,in general ,a prescription for a controlled substance in schedule ,,ii may be partially filled if-- 7i7 it is not prohibited by ,state law2 7ii7 the prescription is written and filled in accordance with the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq471 regulations prescribed by the ,attorney ,general1 and ,state law2 7iii7 the partial fill is requested by the patient or the practitioner that wrote the prescription2 and 7iv7 the total quantity dispensed in all partial fillings does not exceed the total quantity prescribed4 7,b7 ,other circumstances ,a prescription for a controlled substance in schedule ,,ii may be partially filled in accordance with section #acjf4ac of title #ba1 ,code of ,federal ,regulations 7as in effect on the date of enactment of the ,reducing ,unused ,medications ,act of #bjaf74 7#b7 ,remaining portions 7,a7 ,in general ,except as provided in subparagraph 7,b71 remaining portions of a partially filled prescription for a controlled substance in schedule ,,ii-- 7i7 may be filled2 and 7ii7 shall be filled not later than #cj days after the date on which the prescription is written4 7,b7 ,emergency situations ,in emergency situations1 as described in subsection 7a71 the remaining portions of a partially filled prescription for a controlled substance in schedule ,,ii-- 7i7 may be filled2 and 7ii7 shall be filled not later than #gb hours after the prescription is issued4 4 7b7 ,rule of construction ,nothing in this section shall be construed to affect the authority of the ,attorney ,general to allow a prescription for a controlled substance in schedule ,,iii1 ,,iv1 or ,v of section #bjb7;c7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7;c77 to be partially filled4 ,,xviii ,national ,all ,schedules ,prescription ,electronic ,reporting ,reauthorization ,act #ahja4 ,short title ,this title may be cited as the ,national ,all ,schedules ,prescription ,electronic ,reporting ,reauthorization ,act of #bjae4 #ahjb4 ,amendment to purpose ,paragraph 7#a7 of section #b of the ,national ,all ,schedules ,prescription ,electronic ,reporting ,act of #bjje 7,public ,law #aji-fj7 is amended to read as follows3 7#a7 foster the establishment of ,state-administered controlled substance monitoring systems in order to ensure that-- 7,a7 health care providers have access to the accurate1 timely prescription history information that they may use as a tool for the early identification of patients at risk for addiction in order to initiate appropriate medical interventions and avert the tragic personal1 family1 and community consequences of untreated addiction2 and 7,b7 appropriate law enforcement1 regulatory1 and ,state professional licensing authorities have access to prescription history information for the purposes of investigating drug diversion and prescribing and dispensing practices of errant prescribers or pharmacists2 and 4 #ahjc4 ,amendments to controlled substance monitoring program ,section #cii,o of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g-#c7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,a71 by striking or2 7ii7 in subparagraph 7,b71 by striking the period at the end and inserting 2 or2 and 7iii7 by adding at the end the following3 7,c7 to maintain and operate an existing ,state-controlled substance monitoring program4 2 and 7,b7 in paragraph 7#c71 by inserting by the ,secretary after ,grants awarded2 7#b7 by amending subsection 7b7 to read as follows3 7b7 ,minimum requirements ,the ,secretary shall maintain and1 as appropriate1 supplement or revise 7after publishing proposed additions and revisions in the ,federal ,register and receiving public comments thereon7 minimum requirements for criteria to be used by ,states for purposes of clauses 7ii71 7v71 7vi71 and 7vii7 of subsection 7c77#a77;,a74 2 7#c7 in subsection 7c7-- 7,a7 in paragraph 7#a77;,b7-- 7i7 in the matter preceding clause 7i71 by striking 7a77#a77;,b7 and inserting 7a77#a77;,b7 or 7a77#a77;,c72 7ii7 in clause 7i71 by striking program to be improved and inserting program to be improved or maintained2 7iii7 by redesignating clauses 7iii7 and 7iv7 as clauses 7iv7 and 7v71 respectively2 7iv7 by inserting after clause 7ii7 the following3 7iii7 a plan to apply the latest advances in health information technology in order to incorporate prescription drug monitoring program data directly into the workflow of prescribers and dispensers to ensure timely access to patients' controlled prescription drug history2 2 7v7 in clause 7iv71 as redesignated1 by inserting before the semicolon at the end and at least one health information technology system such as an electronic health records system1 a health information exchange1 or an e-prescribing system2 and 7vi7 in clause 7v71 as redesignated1 by striking public health and inserting public health or public safety2 7,b7 in paragraph 7#c7-- 7i7 by striking ,if a ,state that submits and inserting the following3 7,a7 ,in general ,if a ,state that submits 2 7ii7 by striking the period at the end and inserting and include timelines for full implementation of such interoperability4 ,the ,state shall also describe the manner in which it will achieve interoperability between its monitoring program and health information technology systems1 as allowable under ,state law1 and include timelines for implementation of such interoperability42 and 7iii7 by adding at the end the following3 7,b7 ,monitoring of efforts ,the ,secretary shall monitor ,state efforts to achieve interoperability1 as described in subparagraph 7,a74 2 and 7,c7 in paragraph 7#e7-- 7i7 by striking implement or improve and inserting establish1 improve1 or maintain2 and 7ii7 by adding at the end the following3 ,the ,secretary shall redistribute any funds that are so returned among the remaining grantees under this section in accordance with the formula described in subsection 7a77#b77;,b742 7#d7 in subsection 7d7-- 7,a7 in the matter preceding paragraph 7#a7-- 7i7 by striking ,in implementing or improving and all that follows through 7a77#a77;,b7 and inserting ,in establishing1 improving1 or maintaining a controlled substance monitoring program under this section1 a ,state shall comply1 or with respect to a ,state that applies for a grant under subparagraph 7,b7 or 7,c7 of subsection 7a77#a72 and 7ii7 by striking public health and inserting public health or public safety2 and 7,b7 by adding at the end the following3 7#e7 ,the ,state shall report to the ,secretary on-- 7,a7 as appropriate1 interoperability with the controlled substance monitoring programs of ,federal departments and agencies2 7,b7 as appropriate1 interoperability with health information technology systems such as electronic health records systems1 health information exchanges1 and e-prescribing systems2 and 7,c7 whether or not the ,state provides automatic1 real-time or daily information about a patient when a practitioner 7or the designee of a practitioner1 where permitted7 requests information about such patient4 2 7#e7 in subsections 7e71 7f77#a71 and 7g71 by striking implementing or improving each place it appears and inserting establishing1 improving1 or maintaining2 7#f7 in subsection 7f7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,b71 by striking misuse of a schedule ,,ii1 ,,iii1 or ,,iv substance and inserting misuse of a controlled substance included in schedule ,,ii1 ,,iii1 or ,,iv of section #bjb7;c7 of the ,controlled ,substance ,act2 and 7ii7 in subparagraph 7,d71 by inserting a ,state substance abuse agency1 after a ,state health department12 and 7,b7 by adding at the end the following3 7#c7 ,evaluation and reporting ,subject to subsection 7g71 a ,state receiving a grant under subsection 7a7 shall provide the ,secretary with aggregate data and other information determined by the ,secretary to be necessary to enable the ,secretary-- 7,a7 to evaluate the success of the ,state's program in achieving its purposes2 or 7,b7 to prepare and submit the report to ,congress required by subsection 7l77#b74 7#d7 ,research by other entities ,a department1 program1 or administration receiving nonidentifiable information under paragraph 7#a77;,d7 may make such information available to other entities for research purposes4 2 7#g7 by redesignating subsections 7h7 through 7n7 as subsections 7j7 through 7p71 respectively2 7#h7 in subsections 7c77#a77;,a77iv7 and 7d77#d71 by striking subsection 7h7 each place it appears and inserting subsection 7j72 7#i7 by inserting after subsection 7g7 the following3 7h7 ,education and access to the monitoring system ,a ,state receiving a grant under subsection 7a7 shall take steps to-- 7#a7 facilitate prescriber and dispenser use of the ,state's controlled substance monitoring system2 7#b7 educate prescribers and dispensers on the benefits of the system both to them and society2 and 7#c7 facilitate linkage to the ,state substance abuse agency and substance abuse disorder services4 7i7 ,consultation with ,attorney ,general ,in carrying out this section1 the ,secretary shall consult with the ,attorney ,general of the ,united ,states and other relevant ,federal officials to-- 7#a7 ensure maximum coordination of controlled substance monitoring programs and related activities2 and 7#b7 minimize duplicative efforts and funding4 2 7#aj7 in subsection 7l77#b77;,a71 as redesignated by paragraph 7#g7-- 7,a7 in clause 7ii71 by inserting 2 established or strengthened initiatives to ensure linkages to substance use disorder services2 before or affected patient access2 and 7,b7 in clause 7iii71 by inserting and between controlled substance monitoring programs and health information technology systems before 1 including an assessment2 7#aa7 by striking subsection 7m7 7relating to preference71 as redesignated by paragraph 7#g72 7#ab7 by redesignating subsections 7n7 through 7p71 as redesignated by paragraph 7#g71 as subsections 7m7 through 7o71 respectively2 7#ac7 in subsection 7m77#a71 as redesignated by paragraph 7#ab71 by striking establishment1 implementation1 or improvement and inserting establishment1 improvement1 or maintenance2 7#ad7 in subsection 7n71 as redesignated by paragraph 7#ab7-- 7,a7 in paragraph 7#e7-- 7i7 by striking means the ability and inserting the following3 means-- 7,a7 the ability 2 7ii7 by striking the period at the end and inserting 2 or2 and 7iii7 by adding at the end the following3 7,b7 sharing of ,state controlled substance monitoring program information with a health information technology system such as an electronic health records system1 a health information exchange1 or an e-prescribing system4 2 7,b7 in paragraph 7#g71 by striking pharmacy and inserting pharmacist2 and 7,c7 in paragraph 7#h71 by striking and the ,district of ,columbia and inserting 1 the ,district of ,columbia1 and any commonwealth or territory of the ,united ,states2 and 7#ae7 by amending subsection 7o71 as redesignated by paragraph 7#ab71 to read as follows3 7o7 ,authorization of appropriations ,to carry out this section1 there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years from #bjaf through #bjbj4 4 ,amend the title so as to read3 ,an ,act to authorize the ,attorney ,general and ,secretary of ,health and ,human ,services to award grants to address the national epidemics of prescription opioid abuse and heroin use1 and to provide for the establishment of an inter-agency task force to review1 modify1 and update best practices for pain management and prescribing pain medication1 and for other purposes44 ,clerk4